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Tahani Abualteen
Oral manifestations of HIV infection (fully developed AIDS): Oral manifestations of HIV infection are numerous and have been divided into three groups based on the strength of their association with HIV infection
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Oral candidosis The most frequent oral manifestation of HIV infection Candida albicans is the commonest cause but other species, including Azole-resistant species may be involved Infections are usually chronic, showing atypical presentation and are resistant to treatment Psuedomembranous (thrush) and erythematous varieties are seen most frequently o Unlike their counterparts in non-HIV infected patients, they are chronic and may persist for months o May involve any part of the oral mucosa and may be multifocal Hyperplastic candidosis is most frequently seen on the cheeks but the commissures are rarely involved (unlike its counterparts in non-HIV infected patients where it mostly involves the commissures) Prevalence of oral candidosis in HIV-infection varies but is about: o 20% in HIV sero-positive patients have oral candidosis o 70% or more in fully developed AIDS patients have oral candidosis ** However this prevalence is decreasing nowadays with introduction of Highly Active Anti-Retroviral Therapy (HAART) Viral Infections Infections with HSV and VZV in association with HIV infection are more severe and extensive than when occurring in HIV sero-negative patients, and frequently recur
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Kaposis sarcoma o Despite its name, it is not considered a true sarcoma (not a tumor arising from connective tissue) BUT it is a malignant neoplasm of endothelial cells (which are the cells lining blood vessels) o Clinical features: Commonest tumor associated with AIDS (its prevelanact is now low, particular for patients on HAART) More common in males than in females Associated with infection by herpes virus referred to as HHV8 which appears to have a causal role Multifocal tumor (multiple lesions) involving skin & mucosal surfaces Presents first as reddish-purple patches (surface lesion) which then become nodular (soft tissue enlargement) Oral lesions may be the presenting feature and are seen most frequently on the palate Tip of the nose is the most frequent skin/facial site May be resistant to treatment (no curative treatment!) Recurrence BUT NO metastasis 4/6
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