Research Article

Oral Lesions: Poor Markers of Virologic Failure in HIV-Infected Patients on Antiretroviral Therapy

Table 1

Orofacial lesions associated with HIV/AIDS in adults (classification recommended by the EC Clearinghouse on Oral Problems Related to HIV Infection and WHO Collaborating Centre on Oral Manifestations of the Human Immunodeficiency Virus).

Lesions strongly associated with HIV infection
 (i) Candidiasis
    (a) Erythematous
    (b) Pseudomembranous
  (ii) Hairy leukoplakia
  (iii) Kaposi’s sarcoma
  (iv) Non-Hodgkin’s lymphoma
  (v) Periodontal disease
    (a) Linear gingival erythema
    (b) Necrotizing (ulcerative) gingivitis
    (c) Necrotizing (ulcerative) periodontitis

Lesions less commonly associated with HIV infection
 (i) Bacterial infections
    (a) Mycobacterium avium-intracellulare
    (b) Mycobacterium tuberculosis
  (ii) Melanotic hyperpigmentation
  (iii) Necrotizing (ulcerative) stomatitis
  (iv) Salivary gland disease
    (a) Dry mouth due to decreased salivary flow rate
    (b) Unilateral or bilateral swelling of the major
  (v) Thrombocytopenic purpura
  (vi) Ulceration NOS (not otherwise specified)
  (vii) Viral infections
    (a) Herpes simplex virus
    (b) Human papilloma virus (wart-like lesions)
      (1) Condyloma acuminatum
      (2) Focal epithelial hyperplasia
    (c) Verruca vulgaris
      (1) Varicella zoster  virus
      (2) Herpes  zoster
      (3) Varicella

Lesions seen in HIV infection
 (i) Bacterial infections
    (a) Actinomyces israelii
    (b) Escherichia coli
    (c) Klebsiella pneumoniae
  (ii) Cat-scratch disease
  (iii) Drug reactions (ulcerative, erythema multiforme, lichenoid, and toxic epidermolysis)
  (iv) Epithelioid (bacillary) angiomatosis
  (v) Neurologic disturbances
    (a) Facial palsy
    (b) Trigeminal neuralgia
  (vi) Fungal infection other than candidiasis
    (a) Cryptococcus neoformans
    (b) Geotrichum candidum
    (c) Histoplasma capsulatum
    (d) Mucoraceae  (mucormycosis/zygomycosis)
    (e) Aspergillus flavus
  (vii) Recurrent aphthous stomatitis
  (viii) Viral infections
    (a) Cytomegalo virus
    (b) Molluscum contagiosum