Hello Dr. Reznik. I first would like to commend you on your ongoing efforts to help those in need. The world needs more people like you. I am a dental hygiene student. I realize that there are not as many cases of HIV-2 in the U.S. as there are of HIV-1, but in your experience, have you noticed any clinical differences in the oral lesions of the two? Thank you in advance for your time. Sandi

Dear Sandi:

In order to best answer this question, I am including an abstract presentation from the recent 4th International Oral AIDS Conference held in South Africa:

Epidemiology of HIV1 and HIV2 associated oral lesions C. F NDIAYE*, A. BA*, A. GAYE FALL* C. CRITCHLOW* (* University of Dakar – Dental Clinic of Fann Hospital, ** University of Washington – Seattle – Department of Public Health)

We are proposing a study of epidemiology and determinant of oral lesions among HIV1 seropositive, HIV2 seropositive and seronegative heterosexual women and men in Africa, West Africa. Oral pathology is a significant cause of morbidity among those infected with HIV, with from 20 % to over 70 % of HIV infected individuals being reported to develop significant oral pathology at some point during the course of HIV disease.

Objectives :

describe and compare the prevalence and nature of oral lesions in relation to HIV type

Determine the role of immunosuppression and other potential risk factors which may be associated with occurrence of these lesions (factors to be assessed include page, gender, pregnancy, nutritional status, smoking , alcohol consumption, oral hygiene and access to dental care

Methods : this study take place among infectious disease clinic and dental clinic at the Fann hospital. Approximately 3.887 women and 1.280 men were be recreated to determine the prevalence of and risk factors for oral lesions. HIV seropositive subjects will be followed longitudinally over a 2,5 year for an oral screening examination (oral examination, interviewing).

Results : Of the 1.286 men, 375 were infected with HIV1, 50 with HIV2. Of the 3.887 women, 305 were infected with HIV1, 65 with HIV2.

Mucosal lesions were increased with HIV infection –OR adj for gender (56 % C.I = 6.6 (4.7-9.2), with HIV1 patients at higher risk than HIV2 patients (OR adj = 2,5 / 1.1 – 50). Candida was frequently seen. To date, 318 men and 397 women had been further evaluated at the dental service. In this subset, among men, HIV infection was associated with recession and attachment loss. These associations were not seen among women.

Conclusion : the prevalence of oral lesions is high, and oral lesions would be used as clinical skills for the screening and the follow of HIV patients.

I hope this information proves helpful!

DR

PS. All of the abstracts presented at the 4th International Oral AIDS Conference are now online in the Oral Manifestations Section of HIVdent