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Oral Health and HIVOral Health and HIV
          
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Stress...and more stress...
Dec 24, 1999

I stumbled upon your site in search of the mysterious cause of what i now know to be "chelitis", a problem i have been fighting for 2 years now, i'm a 30 yr old female...at first i thought it was cold sores but know now otherwise...or is it a mix of the two? Could you please tell at what stage (years wise) in the HIV progression do these oral problems begin to occur...I am summoning up the courage to go to a doctor for treatment and testing. I desperately need to know how far I have let this advance. Would caprylic acid treat this condition? (as it neutralizes yeast)..What should I eliminate in my diet to aid this problem? The chelitis has progressed from a monthly outbreak to a permanent redness and alternating soreness on either side of my lips all the time...and becoming very noticeable...help...

Response from Dr. Reznik

First, lets discuss angular cheilitis, which is a cracking or fissuring at the corners of the mouth. Whereas it is true that we do see this manifestation in association with HIV disease, it is also seen with Riboflavin (B2) deficiency, people who have ill-fitting dentures and have lost the vertical dimension of occlusion, and people who habitually lick the corners of their mouths. Bottom line: Angular cheilitis does not equal HIV infection!

It is also very difficult to stage a disease based on a symptom or single manifestation. Since there are multiple reasons why a person may develop angular cheilitis, it would be impossible to answer this portion of the question. In people who are HIV positive, angular cheilitis can present at any stage of the disease, but is more common at T-cell counts less than 300.

Treatment: the best therapy, since the primary cause is fungal, would be a topical antifungal cream or ointment such as Nizoral cream, directly applied to the corners of your mouth 4 times a day for 2 weeks.

The key here is to get tested.. I know.. easy to say, but harder to do! We have had several advances in the management of HIV infection the last several years, but one fact is clear: it is better to seek out care early.

Take care,

DR


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