HOW EARLY CAN ORAL MANIFESTATIONS BEGIN?

Question

HELLO, DOCTOR. THANK YOU FOR YOUR WONDERFUL WORK. I'M SOMEWHAT CONFUSED BETWEEN ALL THE INFORMATION THAT IS AVAILABLE. SOME SOURCES SEEM TO INDICATE THAT PRIMARY INFECTION IS CHARACTARIZED ONLY BY FLU LIKE SYMPTOMS AND POSSIBLY A RASH. OTHER SOURCES SEEM TO ADD THAT SYMPTOMS SUCH AS ORAL MANIFESTATIONS MAY BE PRESENT EVEN DURING THE INITIAL PRIMARY INFECTION PHASE (AS OPPOSED TO PRESENTING AS THE DESEASE PROGESSES. SO, WHICH IS IT? CAN ONE PRESENT MOUTH SORES VERY EARLY ON, OR DOES THIS HAPPEN IN THE "SECOND PHASE" THAT SEEMS TO BEGIN YEARS AFTER INFECTION? THANK YOU!!!

Answer

Actually, it is possible to have oral ulcers or even candidiasis during sero-conversion illness as well as the flu-like symptoms, rash etc. The patients that I see all have low T-cell counts (less than 200). These people are much more likely to present with oral manifestations.

I think a key issue to point out is that the ulcers you refer to in sero-conversion illness, are possible, but by themselves are not diagnostic of HIV infection.

Take care,

DR