Precursor oral lesions in HIV positive patients
Keywords:
HIV, HIV infections, oral lesions, CD4+, antiretroviral treatmentAbstract
Introduction: Human immunodeficiency virus (HIV) infection continues to represent a priority challenge in global public health. Among its multiple clinical manifestations, precursor oral lesions are early indicators of immunological deterioration and disease progression. In Ecuador, where the number of HIV cases has increased in the last decade, the study of oral manifestations offers a valuable tool for early detection.
Objective: To identify and analyze the most common oral lesions in patients with a positive HIV serological diagnosis in the province of Tungurahua, Ecuador.
Material and Methods: A cross-sectional, descriptive, and prospective study was conducted at the Ambato Provincial Teaching Hospital. A total of 121 adult individuals, which were divided into HIV-positive patients, healthy high-risk (HR) patients, and healthy individuals were included. Data collection was based on medical records and oral examinations, and statistical analysis was carried out using SPSS v. 23.0 with Chi-square, Risk Ratio (RR), and 95% confidence intervals.
Results: In HIV-positive patients, the main oral conditions were dental caries (64.4%), periodontal disease (46.7%), and oral candidiasis (37.8%). Oral hyperpigmentation (28.9%) and xerostomia (20.0%) were also common. Periodontal disease, oral candidiasis, and oral hyperpigmentation showed a statistically significant association with HIV infection.
Conclusions: Precursor oral lesions are relevant clinical manifestations in people living with HIV, associated with greater immunological impairment. Their early detection should be systematically integrated into comprehensive medical care to optimize timely diagnosis and patient prognosis.
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References
1. Programa Conjunto de las Naciones Unidas sobre el VIH/sida. Enfrentando las desigualdades: Lecciones para la respuesta a pandemias de 40 años de la respuesta al sida [Internet]. Ginebra: Onusida; 2022 [Citado 05/12/2024]. Disponible en: https://www.unaids.org/sites/default/files/media_asset/2021-global-aids-update_es.pdf
2. Bekker LG, Beyrer C, Mgodi N. HIV infection. Nat Rev Dis Primers [Internet]. 2023 [Citado 05/03/2025]; 9(1):42. Disponible en: https://doi.org/10.1038/s41572-023-00452-3.
3. Obeagu EI, Obeagu GU, Musiimenta E. Factors contributing to low utilization of HIV counseling and testing services. Int J Curr Res Med Sci [Internet]. 2023 [Citado 05/03/2025]; 9(2):1-5. Disponible en: https://doi.org/10.22192/ijcrms.2023.09.02.001.
4. World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: Recommendations for a public health approach [Internet]. Geneva: WHO; 2021 [Citado 05/03/2025]. Disponible en: https://docs.bvsalud.org/biblioref/2022/02/1354979/9789240031593-eng.pdf
5. Observatorio Social del Ecuador. Monitoreo del coronavirus covid-19 en Ecuador [Internet]. Ecuador: OSE; 2023 [Citado 05/03/2025]. Disponible en: https://www.covid19ecuador.org/ecuador
6. Yang Y, Yu F, Fei Y, Dong G, Cao P, Liu Y. Immune indices and oral health in patients infected with the human immunodeficiency virus. BMC Oral Health [Internet]. 2023 [Citado 05/03/2025]; 23(1009):1-9. Disponible en: https://doi.org/10.1186/s12903-023-03752-y
7. Sutini S, Rahayu SR, Saefurrohim MZ. Prevalence and determinants of opportunistic infections in HIV patients: A cross-sectional study in the city of Semarang. Ethiop J Health Sci [Internet]. 2022 [Citado 05/03/2025],32(4):809-16. Disponible en: https://doi.org/10.4314/ejhs.v32i4.18
8. Ministerio de Salud Pública. Informe Anual de la Situación Epidemiológica del VIH Ecuador [Internet]. Ecuador: MSP; 2022 [Citado 05/03/2025]. Disponible en: https://www.salud.gob.ec/wp-content/uploads/2024/04/INFORME-ANUAL-DE-VIH-2022_MSP.pdf
9. Farfán G. Prevalence and epidemiological analysis of opportunistic infections in HIV/AIDS patients in Ecuador. INSPILIP [Internet]. 2025 [Citado 05/03/2025];9(28). Disponible en: https://www.inspilip.gob.ec/index.php/inspi/article/view/713
10. Birungi N, Fadnes LT, Engebretsen IMS, Tumwine JK, Astrom AN. Antiretroviral treatment and its impact on oral health outcomes in 5 to 7 year old Ugandan children: A 6 year follow-up visit from the ANRS 12174 randomized trial. Medicine [Internet] 2020 [Citado 05/03/2025] 99(39):e22352. Disponible en: https://doi.org/10.1097/MD.0000000000022352
11. Novianti Y, Sufiawati I. Clinical Assessment and Management in Improving the Quality of Life of HIV/AIDS Patients with Oral Candidiasis: A Case Series. HIV AIDS [Internet]. 2023 [Citado 05/03/2025];15:683-96. Disponible en https://doi.org/10.2147/HIV.S434175
12. Lomelí SM, González LA, Ruiz A de J, Lomelí MA, Martínez SI, Mercado AE, et al. Oral manifestations associated with HIV/AIDS patients. Medicina. (Kaunas) [Internet]. 2022 [Citado 05/03/2025]; 58(9):1214. Disponible en: https://doi.org/10.3390/medicina58091214
13. Jana PK, Sahu SK, Sivaranjini K, Hamide A, Roy G. Prevalence of oral lesions and its associated risk factors among PLHIV availing anti retroviral therapy from a selected tertiary care hospital, Puducherry A cross sectional analytical study. Indian J Community Med [Internet]. 2022 [Citado 05/03/2025];47(2):235–9. Disponible en: https://doi.org/10.4103/ijcm.ijcm_850_21
14. Saltos C, Calva SV, Rodríguez AA, Cabrera JL, Lara AE. Lesiones en la Mucosa oral en Personas Viviendo con VIH/SIDA. Revisión de Literatura. Ciencia [Internet]. 2024 [Citado 02/03/2024]; 8(1):8182-96. Disponible en: https://ciencialatina.org/index.php/cienciala/article/view/10142
15. Noiman A, Esber A, Wang X, Bahemana E, Adamu Y, Iroezindu M, et al. Clinical factors and outcomes associated with immune non-response among virally suppressed adults with HIV from Africa and the United States. Sci Rep [Internet]. 2022 [Citado 02/03/2024]; 12:1196. Disponible en: https://doi.org/10.1038/s41598-022-04866-z
16. Taramasso L, Labate L, Briano F, Brucci G, Mora S, Blanchi S, et al. CD4+ T lymphocyte recovery in the modern antiretroviral therapy era: toward a new threshold for defining immunological non-responders. Front Virol [Internet]. 2023 [Citado 02/03/2024]; 2:822153. Disponible en: https://www.frontiersin.org/journals/virology/articles/10.3389/fviro.2022.822153/full https://doi.org/10.3389/fviro.2022.822153
17. Aitken J, Camargo B, Uchoa AC, Pineda D, Maturana A. Oral lesions diagnosis associated with HIV. Report of 3 clinical cases. Revista Estomatológica Herediana [Internet]. 2021 [Citado 02/03/2024];31(2):140-5. Disponible en: https://www.redalyc.org/articulo.oa?id=421567917013
18. Tarozzi M, Baruzzi E, Decani S, Tincati C, Santoro A, Moneghini L, et al. HIV-Related oral mucosa lesions: a cross-sectional study on a cohort of Italian patients. Biomedicines [Internet]. 2024 [Citado 05/03/2025];12:436. Disponible en: https://doi.org/10.3390/biomedicines12020436
19. Cordeiro SA, Lopes TCP, Boechat AL, Gonçalves RL. Weight loss and mortality in people living with HIV: a systematic review and meta-analysis. BMC Infect Dis [Internet]. 2024 [Citado 05/03/2025];24(1):34. Disponible en: https://doi.org/10.1186/s12879-023-08889-3
20. Lustosa BK, Sorgatto D, Araújo CA, Silvestre F, Assis R, Sibele RM. Associated oral manifestations with HIV southeastern Brazilian patients on antiretroviral therapy. Brazilian Journal of Otorhinolaryngology [Internet]. 2023 Jan 02. [Citado 05/03/2025];89(3):425-431. Disponible en: https://doi.org/10.1016/j.bjorl.2023.01.001
21. Maloth S, Shrinivas TR, Krishna Pramod B, Nagarathna PJ. Prevalence of oromucosal lesions in HIV positive patients receiving haart-A prospective clinical study. J Family Med Prim Care [Internet]. 2020 [Citado 05/03/2025]; 9(9):4821-5. Disponible en: https://doi.org/10.4103/jfmpc.jfmpc_881_20
22. da Rocha G de CT, de Souza RR, Oliveira AB, Ribeiro Al, Fernandes AS, Valois R, et al. Evaluation of sociodemographic factors and prevalence of oral lesions in people living with HIV from Cacoal, Rondônia, Amazon Region of Brazil. Int J Environ Res Public Health [Internet]. 2022 [Citado 02/03/2024]; 19(5):2614. Disponible en: https://doi.org/10.3390/ijerph19052614
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