Canker Sores and HIV Infection

Question

I'm at the end of my rope! I've been HIV+ for 5 1/2 years, and have always have very good numbers. High T-cells, always over 600... low viral load, always under 10,000. Four months ago, I actually had an undetectable viral load - and I have never been on medication!

However, about 1 year ago, I began getting canker sores... constantly. I have been getting them since I was a child, usually after biting my cheek. Nowadays, however, they are a constant, often come up in clusters, and as soon as they begin healing, one or more will arise. They are so painful and frustrating.

My doctor swapped one of them, and confirmed that they are not the result of a herpes infection. What could be the cause? Is it possible that my HIV infection, even with excellent numbers for the past 5 1/2 years, is the cause of this onslaught?

I also have to add... about three months ago, I started taking multivitamins, switched to Sensodyne toothpaste, and stopped eating sharp foods (no chips!). I have noticed an improvement in the number of canker sores, and a reduction in their size and duration - but they are not completely gone...

So, any ideas? Are there any more tests I can run to figure out what else could be the cause? Or maybe... it's time to start meds? Maybe my HIV infection is the cause?

Thank you so much for your help! :)

Answer

Cancer sores (aphthous ulcers) are fairly common in general population (and often frustrating) and are likely more common in HIV+ persons even with good CD4 counts. Often cause is idiopathic in general population (unknown cause). A modest subset seem to get better with zinc supplementation in my experience. I can't say with high confidence that starting HIV meds will decrease the problem-it could help but data on that is limited. KH