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Mouth sores
Jun 11, 1999

Would herpes in your mouth not on the outside be a sign of HIV? I had a possible exposure about 7 months ago and have tested - so far but had a recent mouth sores the doctor said taht it is herpes, he gave me some medicine, it went away, now a few days later it is back, just like before? Should I continue to test for HIV? Please answer my questions. Thank you for your time.

Response from Dr. Reznik

The answer to your question is no. Herpetic lesions inside the oral cavity are not signs of HIV exposure, rather they are a sign of exposure to HSV, the virus that causes these lesions. To insure that you have an accurate diagnosis of these lesions, a HSV culture should be performed.

Herpetic lesions inside the oral cavity normally appear on keratinized tissue such as the gingiva

http://www.hivdent.org/slides/herpes_simplex_virus_hsv_gingival_tissue.htm

and hard palate http://www.hivdent.org/slides/herpes_simplex_virus_hsv_hard_palate.htm.

It is not uncommon for these lesions to recur. Treatment involves 1 gram a day of acyclovir for 7 to 10 days. Actually since acyclovir is now generic and available in a 400 mg dose, I usually write 400 mg three times a day for the 7 to 10 days. If recurrence continues to be a problem, it is acceptable for your provider to write a prophylactic dose of 400 mg twice a day.

Whether or not you continue to test for HIV depends on how long since your last exposure.

I hope this helps!

DR


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