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Acharya A, Muralidharan S, Mallaiah P, Geetha S. Dental caries prevalence among HIV adult population in India: A systematic review. J Oral Maxillofac Pathol 2021; 24:588. [PMID: 33967519 PMCID: PMC8083402 DOI: 10.4103/jomfp.jomfp_64_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/18/2020] [Indexed: 11/06/2022] Open
Abstract
Dental caries is a universal disease. Untreated dental caries adds to the existing burden of diseases. It is necessary to have national data on the same, especially in HIV cases, to understand the epidemiological aspects and formulate a treatment plan for the population. Hence, a systematic review was carried out to collectively report the dental caries prevalence among this population. A systematic search for articles was done in PubMed and Google Scholar using the keywords: Dental Caries, India, HIV, AIDS and adults from January 1990 to December 2019. All freely available full-text articles were evaluated based on the inclusion criteria. Only four articles fulfilled the criteria based on qualitative analysis. Decayed, Missing and Filled Teeth index was used to record dental caries. Risk factors related to the same were not specified by any of the authors. Studies were not from different regions of India. More epidemiological studies are needed to understand the prevalence rate and correlated to dental caries among HIV-positive population in India.
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Affiliation(s)
- Arunkumar Acharya
- Department of Public Health Dentistry, Navodaya Dental College and Hospital, Raichur, Karnataka, India
| | - Shrikanth Muralidharan
- Department of Public Health Dentistry, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Pramila Mallaiah
- Department of Public Health Dentistry, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - S Geetha
- Department of Public Health Dentistry, MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
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Kalanzi D, Mayanja-Kizza H, Nakanjako D, Mwesigwa CL, Ssenyonga R, Amaechi BT. Prevalence and factors associated with dental caries in patients attending an HIV care clinic in Uganda: a cross sectional study. BMC Oral Health 2019; 19:159. [PMID: 31324242 PMCID: PMC6642521 DOI: 10.1186/s12903-019-0847-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Chronic Human Immunodeficiency Virus (HIV) infection is associated with reduced saliva flow rate due to infiltration of HIV and proliferation of CD8 lymphocytes in salivary glands. It is unclear whether HIV infection and antiretroviral therapy (ART) increase caries risk. This study aimed to determine the prevalence and factors associated with dental caries in HIV infected adults attending the Mulago Immune Suppression Syndrome (ISS) clinic in Uganda. METHODS A cross-sectional study was conducted among HIV infected persons. Dental examinations were performed by two calibrated dentists using the WHO Radke's caries classification criteria and reported using the decayed (D), missing (M), filled (F), teeth (DMFT) index. The prevalence and factors associated with dental caries was examined through linear regression analyses. RESULTS Overall, 748 participants (females = 491, 65.6%) with a mean age of 39 ± 9.4 years were included in the final analysis; of whom 83.7% had caries (DMFT> 0), with a significantly (p < 0.05) higher prevalence among females 86.6% than males 78.2%. The mean DMFT was 5.9 ± 5.5, with statistically significant differences based on gender (males 4.9 ± 4.8 and females 6.3 ± 5.9, p < 0.05) and duration on ART (< 2 years 4.8 ± 4.4, > 2 years but < 5 years 5.7 ± 5.5, > 5 years 6.6 ± 6.0 p < 0.05). The majority (67.2%) of participants reported brushing their teeth twice or more a day, and sugar intake was not associated with dental caries. CONCLUSION Caries prevalence is high among HIV infected adults under care. Duration of ART was associated with increased risk and severity of caries. Therefore, we recommend integration of dental care in HIV treatment programs.
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Affiliation(s)
- Dunstan Kalanzi
- Department of Dentistry School of Health Sciences, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda.
| | - Harriet Mayanja-Kizza
- Department of Medicine School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Damalie Nakanjako
- Department of Medicine School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Catherine Lutalo Mwesigwa
- Department of Dentistry School of Health Sciences, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health San Antonio School of Dentistry, San Antonio, TX, USA
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Arutyunyan S, Uhde M. Benign Lymphoepithelial Lesion of the Parotid Gland in the Setting of HAART. J Int Assoc Provid AIDS Care 2016; 16:120-124. [PMID: 28034345 DOI: 10.1177/2325957416686193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The benign lymphoepithelial lesion is a rare and diagnostically challenging entity. Classically, these lesions present as early manifestation of HIV infection and are rarely seen in those on highly active antiretroviral therapy. We describe 2 rare cases of HIV-associated lympho-epithelial lesions of parotid gland in a 37-year-old female and a 47-year-old male receiving antiretroviral therapy. The lesions were characterized with respect to clinical features, as well as histopathology and radiology findings. Fine-needle aspiration cytology revealed benign squamous epithelium and lymphocytes. Sonographic evaluation of the parotid gland demonstrated intraparotid solid hypoechoic nodule. Computed tomography showed cystic and solid masses. These lesions were diagnosed as benign lymphoepithelial lesions in both cases. To our knowledge, this is the first report in the published literature describing newly occurring benign lymphoepithelial lesions in patients on antiretroviral therapy.
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Affiliation(s)
- Sergey Arutyunyan
- 1 Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA
| | - Matthew Uhde
- 2 Palm Beach Consortium for Graduate Medical Education, JFK Medical Center-North Campus, West Palm Beach, FL, USA
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Syebele K, Munzhelele TI. Oral mucocele/ranula: Another human immunodeficiency virus-related salivary gland disease? Laryngoscope 2014; 125:1130-6. [PMID: 25446909 DOI: 10.1002/lary.25058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/27/2014] [Accepted: 11/05/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To describe clinical characteristics of oral mucoceles/ranulas, with a focus on human immunodeficiency virus (HIV)-related salivary gland diseases. STUDY DESIGN A descriptive and clinical study, with review of patient data. MATERIAL AND METHODS We reviewed 113 referred cases of oral mucocele. The following anatomical sites were identified: lip, tongue, and floor of the mouth (simple ranulas), as well as plunging ranulas. The age and gender data of the patients with oral mucoceles were recorded. The HIV status of the patients and other information were reviewed. RESULTS There were 30 (26.5%) males and 83 (73.5%) females. Most patients were below 30 years of age, with the peak frequency in the first and second decade. Ranula (simple and plunging) represented 84.1% of the mucocele locations. Mucocele on the lips represented 10.6%. Seventy-two (63.7%) patients were HIV positive; and 97.2% of them had ranulas. Thirty-eight (33.6%) patients presented with plunging ranulas; and 92.1% of them were HIV positive, compared with two patients presenting with plunging ranulas in the HIV-negative group. These results strongly suggest that an HIV-positive patient is statistically (P < 0.001) more at risk of presenting with not only a simple, but also a plunging ranula type. CONCLUSION This study presents a different clinical picture of oral mucoceles/ranulas, as observed in HIV-positive patients. Additionally, it suggests a possible clinical link between the two pathologies. The authors strongly support the suggestion that oral mucocele/ranula is an HIV-related salivary gland disease. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Kabunda Syebele
- Department of Maxillo-Facial and Oral Surgery, University of Pretoria, South Africa
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López-Verdín S, Andrade-Villanueva J, Zamora-Perez AL, Bologna-Molina R, Cervantes-Cabrera JJ, Molina-Frechero N. Differences in Salivary Flow Level, Xerostomia, and Flavor Alteration in Mexican HIV Patients Who Did or Did Not Receive Antiretroviral Therapy. AIDS Res Treat 2013; 2013:613278. [PMID: 24455222 PMCID: PMC3880737 DOI: 10.1155/2013/613278] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 11/17/2013] [Indexed: 02/06/2023] Open
Abstract
Introduction. Objective and subjective alterations related to salivary flow have been reported in patients infected with human immunodeficiency virus (HIV), and these alterations are associated with the introduction of antiretroviral therapy. The aim of the current study was to discern whether these alterations are disease induced or secondary to drug therapy. Objective. The objective was to determine the relationships between low salivary flow, xerostomia, and flavor alterations in HIV patients who did or did not receive antiretroviral therapy. Materials and Methods. In this cross-sectional study, HIV patients were divided into two groups based on whether they had received antiretroviral therapy. Those patients with a previous diagnosis of any salivary gland disease were excluded. A survey was used to assess subjective variables, and colorimetry and salivary flow rates were measured using the Schirmer global test. Results. A total of 293 patients were included. The therapy group showed a significantly lower average salivary flow than did the group without therapy, and we observed that the flow rate tended to decrease after one year of therapy. The results were not conclusive, despite significant differences in xerostomia and flavor alteration between the groups. Conclusion. The study results suggest that antiretroviral therapy can cause cumulative damage that affects the amount of salivary flow.
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Affiliation(s)
- Sandra López-Verdín
- 1Instituto de Investigación en Odontología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, 44340 Guadalajara, JAL, Mexico
| | - Jaime Andrade-Villanueva
- 2Unidad de VIH del Hospital Civil de Guadalajara “Fray Antonio Alcalde”, 44340 Guadalajara, JAL, Mexico
| | - Ana Lourdes Zamora-Perez
- 1Instituto de Investigación en Odontología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, 44340 Guadalajara, JAL, Mexico
| | - Ronell Bologna-Molina
- 3Departamento de Investigación, Facultad de Odontología, Universidad Juárez del Estado de Durango, 34100 Durango, DGO, Mexico
- 4Facultad de Odontología, Universidad de la República (UDELAR), 11600 Montevideo, MVD, Uruguay
| | - José Justino Cervantes-Cabrera
- 1Instituto de Investigación en Odontología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, 44340 Guadalajara, JAL, Mexico
| | - Nelly Molina-Frechero
- 5Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, Xochimilco, Calz del Hueso 1100 Villa Quietud, Coyoacán, 04960 Ciudad de México, DF, Mexico
- *Nelly Molina-Frechero:
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Steehler MK, Steehler MW, Davison SP. Benign lymphoepithelial cysts of the parotid: long-term surgical results. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2012; 4:81-6. [PMID: 22719215 PMCID: PMC3377388 DOI: 10.2147/hiv.s27755] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Benign lymphoepithelial cysts are a widely recognized cause of parotid gland swelling in patients infected with the human immunodeficiency virus (HIV). These cysts are pathognomonic for HIV. The cysts frequently grow to be exceptionally large, causing physical deformity and gross asymmetry of facial contour. This clinical commentary analyzes this cosmetically deforming disease entity and the many treatments that accompany it. The patient presented in this paper is a surgical case-control. The case is a microcosm for our findings upon review of the literature. Treatment options for benign lymphoepithelial cysts include repeated fine-needle aspiration and drainage, surgery, radiotherapy, sclerotherapy, and conservative therapy, with institution of highly active antiretroviral therapy medication. Based on this surgical case-control and our review of the literature, it is concluded that surgical intervention offers the best cosmetic result for these patients.
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Affiliation(s)
- Matthew K Steehler
- Georgetown University Hospital Department of Otolaryngology Head and Neck surgery, Washington, DC, USA
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Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients. ACTA ACUST UNITED AC 2011; 111:205-10. [DOI: 10.1016/j.tripleo.2010.09.067] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 09/20/2010] [Accepted: 09/21/2010] [Indexed: 01/08/2023]
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Kabenge C, Ng S, Muyinda Z, Ameda F. Diagnostic ultrasound patterns of parotid glands in human immunodeficiency virus-positive patients in Mulago, Uganda. Dentomaxillofac Radiol 2010; 39:389-99. [PMID: 20841456 DOI: 10.1259/dmfr/23992216] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine sonographically, in parotid glands of human immunodeficiency virus-positive patients, the condition of glands with or without enlargement, and propose a classification system for the patterns observed using diagnostic ultrasound imaging. METHODS In this prospective clinical study, ultrasound scans were performed on 200 patients aged 4-62 years at Mulago Hospital, Uganda. RESULTS There were four main distinct ultrasound pathological patterns in the parotids, i.e. lymphocytic aggregations (LAs), lymphoepithelial cysts (LECs), fatty infiltration (FI) and lymphadenopathy only. There were additional subdivisions depending on the presence of echogenic foci and intraparotid lymphadenopathy. Of those patients (n = 64) without parotid enlargement, only 8% showed normal ultrasound features, whereas 34% showed LECs and 31% showed LAs. Of those (n = 136) with parotid enlargement, 46% showed LECs, 23% showed FI and 15% showed LAs. The overall prevalence of LECs in the study sample was 42%. LECs were multiple, mainly between 7 mm and 12 mm in diameter and 26% showed internal echogenic foci either mobile or stationary. In contrast, LAs tended to be ill-defined, less than 5 mm and were not associated with posterior acoustic enhancement. Features differentiating LAs from LECs have not been previously described. Parotid FI (lipodystrophy) was noted in patients on highly active antiretroviral therapy, who showed lesser prevalence of LECs after 12 months of treatment. CONCLUSIONS Our study of 200 patients is probably the largest such study in the English language literature. The wide spectrum of diagnostic ultrasound patterns was categorized into four main groups (ten subgroups).
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Affiliation(s)
- C Kabenge
- Department of Oral Surgery, Mulago Hospital, Uganda
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Nittayananta W, Talungchit S, Jaruratanasirikul S, Silpapojakul K, Chayakul P, Nilmanat A, Pruphetkaew N. Effects of long-term use of HAART on oral health status of HIV-infected subjects. J Oral Pathol Med 2010; 39:397-406. [PMID: 20202089 DOI: 10.1111/j.1600-0714.2009.00875.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of this study was to determine the effects of long-term use of highly active antiretroviral therapy (HAART) on oral health status of HIV-infected subjects. METHODS Oral examination and measurement of saliva flow rate of both unstimulated and wax-stimulated whole saliva were performed in HIV-infected subjects with and without HAART, and in non-HIV individuals. The following data were recorded; duration and risk of HIV infection, type and duration of HAART, CD4 cell count, viral load, presence of orofacial pain, oral dryness, oral burning sensation, oral lesions, cervical caries, and periodontal pocket. Multiple logistic regression analysis was performed to determine the effects of long-term use of HAART on oral health status of HIV-infected subjects. RESULTS One hundred and fifty-seven HIV-infected subjects - 99 on HAART (age range 23-57 years, mean 39 years) and 58 not on HAART (age range 20-59 years, mean 34 years) - and 50 non-HIV controls (age range 19-59 years, mean 36 years) were enrolled. The most common HAART regimen was 2 NRTI + 2 NNRTI. HIV-infected subjects without HAART showed greater risks of having orofacial pain, oral dryness, oral lesions, and periodontal pockets than those with short-term HAART (P < 0.01). The subjects with long-term HAART were found to have a greater risk of having oral lesions than those with short-term HAART (P < 0.05). The unstimulated and stimulated salivary flow rates of the subjects with HAART were significantly lower than in those without HAART (P < 0.05). CONCLUSION We conclude that long-term HAART has adverse effects on oral health status of HIV-infected subjects.
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Affiliation(s)
- Wipawee Nittayananta
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
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Syebele K. Regression of both oral mucocele and parotid swellings, following antiretroviral therapy. Int J Pediatr Otorhinolaryngol 2010; 74:89-92. [PMID: 19879006 DOI: 10.1016/j.ijporl.2009.09.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 09/25/2009] [Accepted: 09/29/2009] [Indexed: 01/19/2023]
Abstract
HIV-salivary gland associated disease is a well accepted concept in the HIV-related literature. Parotid swellings, especially in its cystic benign lymphoepithelial form, have been largely reported. Oral mucoceles (ranulas) were also associated with HIV in some publications. The exact nature of this link between mucoceles and HIV is still to be clarified. The mainstream treatment of most of parotid pathologies and oral mucoceles remains surgical approach. Strong evidences do, however, exist about lymphopithelial lesions of parotid glands that have been successfully treated with antiretroviral drugs. We present a case of intraoral mucocele, coexisting with bilateral parotid gland lymphoepithelial lesions, on a 2-year-old HIV-positive patient. Both parotid gland swellings and the sublingual mucocele have completely regressed following antiretroviral therapy. No surgical intervention was required. Conversely to benign lymphoepithelial lesions of parotid glands, the regression of oral mucocele on HIV-positive patient, following antiretroviral drugs therapy appears to be a rare phenomenon.
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Affiliation(s)
- Kabunda Syebele
- Oral and Dental hospital, Department of Maxillofacial and Oral Surgery, University of Pretoria, PO Box 1266, Pretoria 0001, South Africa.
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Ihrler S, Adam P, Guntinas-Lichius O, Harrison J, Weiler C. Mustererkennung zur Differenzialdiagnose lymphoepithelialer Läsionen der Speicheldrüsen. DER PATHOLOGE 2009; 30:432-41. [DOI: 10.1007/s00292-009-1203-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Leao JC, Ribeiro CMB, Carvalho AAT, Frezzini C, Porter S. Oral complications of HIV disease. Clinics (Sao Paulo) 2009; 64:459-70. [PMID: 19488613 PMCID: PMC2694251 DOI: 10.1590/s1807-59322009000500014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/18/2009] [Indexed: 12/13/2022] Open
Abstract
Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS.
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Affiliation(s)
- Jair C Leao
- Departamento de Clinica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, PE, Brazil.
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Navazesh M, Mulligan R, Karim R, Mack WJ, Ram S, Seirawan H, Greenspan J, Greenspan D, Phelan J, Alves M. Effect of HAART on salivary gland function in the Women's Interagency HIV Study (WIHS). Oral Dis 2008; 15:52-60. [PMID: 19017280 DOI: 10.1111/j.1601-0825.2008.01456.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the impact of highly active antiretroviral therapy (HAART) on salivary gland function in human immunodeficiency virus (HIV) positive women from the Women's Interagency HIV Study (WIHS). DESIGN Longitudinal cohort study. SUBJECTS AND METHODS A total of 668 HIV positive women from the WIHS cohort with an initial and at least one follow-up oral sub-study visit contributed 5358 visits. Salivary gland function was assessed based on a dry mouth questionnaire, whole unstimulated and stimulated salivary flow rates, salivary gland enlargement or tenderness and lack of saliva on palpation of the major salivary glands. MAIN OUTCOME MEASURES Changes in unstimulated and stimulated flow rates at any given visit from that of the immediate prior visit (continuous variables). The development of self-reported dry mouth (present/absent), enlargement or tenderness of salivary glands (present/absent), and absence of secretion on palpation of the salivary glands were binary outcomes (yes/no). RESULTS Protease Inhibitor (PI) based HAART was a significant risk factor for developing decreased unstimulated (P = 0.01) and stimulated (P = 0.0004) salivary flow rates as well as salivary gland enlargement (P = 0.006) as compared with non-PI based HAART. CONCLUSIONS PI-based HAART therapy is a significant risk factor for developing reduced salivary flow rates and salivary gland enlargement in HIV positive patients.
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Affiliation(s)
- M Navazesh
- USC School of Dentistry, Los Angeles, CA 90089-0641, USA.
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Eveson JW, Speight PM. Non-neoplastic lesions of the salivary glands: New entities and diagnostic problems. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.cdip.2005.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
HIV infection affects residents of all countries of the world, but the greater majority of affected individuals reside in the developing world. In the past decade there have been substantial changes in the management of HIV disease, particularly the introduction of highly active antiretroviral therapy (HAART). Such agents have reduced significantly the morbidity and mortality associated with HIV disease, however, they are not available for most HIV-infected individuals in the developing world. There is now considerable understanding of the molecular epidemiology, transmission and therapy of the common opportunistic oral infections of HIV disease, and as a consequence of improved anti-HIV strategies, the frequency and severity of oral disease associated with HIV infection have reduced considerably, although HAART may predispose to human papilloma virus infection of the mouth and potentially increase the risk of later oral squamous cell carcinoma. Despite advances in clinical care the majority of individuals with HIV disease worldwide will continue to develop oral disease, as they are resident in the developing world and do not have ready access to even simple therapies.
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Affiliation(s)
- Cristina Frezzini
- Oral Medicine Division of Maxillofacial Diagnostic, Medical and Surgical Sciences, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, London, UK
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Morales-Aguirre JJ, Patiño-Niño JA, Mendoza-Azpiri M, Villalobos-Acosta CP, Gómez-Barreto D, de la Torre C, Cashat-Cruz M. Parotid Cysts in Children Infected With Human Immunodeficiency Virus. ACTA ACUST UNITED AC 2005; 131:353-5. [PMID: 15837907 DOI: 10.1001/archotol.131.4.353] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- José Juan Morales-Aguirre
- Department of Infectious Diseases, Epidemiology, and Otolaryngology, Hospital Infantil de México Federico Gómez, México DF, México
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Rivera H, Nikitakis NG, Castillo S, Siavash H, Papadimitriou JC, Sauk JJ. Histopathological analysis and demonstration of EBV and HIV p-24 antigen but not CMV expression in labial minor salivary glands of HIV patients affected by diffuse infiltrative lymphocytosis syndrome. J Oral Pathol Med 2003; 32:431-7. [PMID: 12846790 DOI: 10.1034/j.1600-0714.2003.00061.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The diffuse infiltrative lymphocytosis syndrome (DILS) in HIV patients is characterized by the persistence of CD8-circulating lymphocytes and lymphocytic infiltration, predominantly in salivary glands. METHODS We examined seven HIV-positive patients with bilateral parotid enlargement and sicca symptoms. Minor labial salivary gland biopsies were performed in all patients and submitted for histopathological analysis and immunohistochemistry for CD4, CD8, cytomegalovirus (CMV), LMP-EBV protein, and HIV p-24 protein. RESULTS In all cases, lymphocytic infiltration of the minor salivary glands, mainly periductal, was found. Acinar atrophy, ductal ectasia, and mild to moderate fibrosis were also observed. We noticed strong immunohistochemical reaction for LMP-EBV and p-24 proteins in ductal cells in all cases, while staining for CMV was consistently negative. The lymphocytes were positive for CD8, but consistently negative for CD4. CONCLUSIONS A role of Epstein-Barr virus (EBV) and HIV, but not CMV, in the pathogenesis of DILS, is suggested by our immunohistochemical findings.
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Affiliation(s)
- Helen Rivera
- Faculty of Dentistry, Central University of Venezuela, Venezuela
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Abstract
Much has been learned about HIV disease during its first 20 years of existence in North America. The virus can now be successfully suppressed by HAART therapy, yet complete viral eradication from the body has not been demonstrated, and HIV transmissions continue to occur at an alarming rate. With support of the immune system, many HIV-infected patients will avoid oral and systemic opportunistic illnesses (or at least significantly prolong their time to onset). The number of HIV-infected patients under dental care is expected to increase in the future. Thus, dentists are fortunate that oral health care can be provided safely in the community setting for all but the very sickest of AIDS patients.
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Affiliation(s)
- Lauren L Patton
- Department of Dental Ecology, School of Dentistry, CB #7450, 388 Dental Office Building, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA.
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