Oral manifestations after immune reconstitution in HIV patients on HAART.
In order to verify possible association between immune reconstitution inflammatory syndrome (IRIS) and oral manifestations (OMs), we selected AIDS patients who had low CD4 count before the initiation of highly active antiretroviral therapy (HAART) and who returned three months later for therapy evaluation. The oral lesions observed three months after the initiation of HAART were evaluated and associated with the type of antiretroviral therapy (ART), CD4 count and HIV-RNA load levels (before and three months after HAART initiation). A total of 105 patients matched the selected criteria. Immune reconstitution (IR) was identified in 35.2%. Among these patients, the mean CD4 cell count rose from 105.97 to 330.29 and the mean viral load dropped from 168.005 (log 5.22) to 21.852 (log 4.33). There was no significant difference in age (P = 0.78), sex (P = 0.41) or previous history of ART (P = 0.55) between IR and non-IR patients. In the IR group, the most common OM was parotid enlargement (57.14%) (P = 0.019), whereas in the non-IR group candidiasis (46.15%) was the most common OM. The results of our study suggest that the parotid gland enlargement found in the studied population might be an IRIS event, as it was found in patients with IR three months after the initiation of HAART.
Ortega
Karem L
KL
Department of Oral Pathology, Special Care Dentistry Center, University of São Paulo, São Paulo, SP, Brazil. klortega@usp.br
Ceballos-Salobreña
Alejandro
A
Gaitán-Cepeda
Luis A
LA
Magalhães
Marina G
MG
D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D016516:CD4-CD8 Ratio; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000453:epidemiology / Q000209:etiology*; D007108:Immune Tolerance / Q000187:drug effects; D007249:Inflammation / Q000139:chemically induced* / Q000473:pathology; D009059:Mouth Diseases / Q000453:epidemiology / Q000382:microbiology*; D009894:Opportunistic Infections / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence
D019380:Anti-HIV Agents