HIV related oral lesions are less common since HAART

The use of highly active antiretroviral therapy (HAART) that includes a protease inhibitor by patients with HIV infection has reduced the prevalence of HIV-associated oral lesions by more than 30%. Dr. Luis A. Gaitan-Cepeda, of Universidad Nacional Autonoma de Mexico, and colleagues examined the prevalence of oral lesions in 154 AIDS patients undergoing HAART that included a protease inhibitor. All of the patients were treated at the Regional Hospital “Carlos Haya” in Malaga, Spain, from September 1997 to May 1998.

Overall, 53.2% of patients had HIV-related oral lesions. Oral candidiasis was the most common type of lesion, accounting for 34.4% of all cases. Other lesions included hairy leucoplakia (26.6%), xerostomia (15.5%), herpes simplex labialis (1.9%) and periodontitis-gingivitis (0.6%). No cases of oral Kaposi’s sarcoma were identified. Male patients who reported sexual contact with other males had the lowest rate of oral lesions, according to the report, published in the December issue of AIDS Patient Care and STDs. The highest rates of HIV-associated oral lesions were observed in intravenous drug users and patients with viral loads higher than 10,000 copies/mL and CD4+ count below 200 cells per microliter.

“To the best of our knowledge, this is the first time that the prevalence of oral lesions in a population of patients with AIDS undergoing HAART, including protease inhibitors, is reported,” Dr. Gaitan-Cepeda’s group writes. The greatest decrease in prevalence was seen in lesions associated with viral infections, they add. “Although we do not have a valid explanation for this, it seems likely that the combination of reverse transcriptase inhibitors and protease inhibitors…improved the immunologic conditions of the patients,” they suggest.