Additional prevalence data are needed from developing countries prior to substantially altering the 1993 ECC/WHO Classification of oral lesions associated with adult HIV infection. The workshop confirmed current oral disease diagnostic criteria.
Oral manifestations are common in paediatric HIV infection and are possible predictors of HIV disease progression. Primary care of HIV-infected children should include periodic oral examinations to monitor their HIV disease progression and to alleviate symptoms associated with oral opportunistic infections.
HIV infection and AIDS are spreading rapidly among the world's children, especially among African-American and Hispanic children in the USA, and those in developing countries. Although recent research has identified several ways of preventing perinatal transmission of HIV, most of these methods are too expensive for widespread use in developing countries, where the epidemic is most severe. Oral manifestations are early and common clinical indicators of HIV infection and progression in children, as in adults, although the specific manifestations differ between adults and children. Oropharyngeal candidiasis is the most common sign of HIV infection in children and is significantly associated with markers of HIV disease progression. Other common oral manifestations in children include herpes simplex, linear gingival erythema, parotid enlargement and recurrent aphthous ulceration. Further research is needed on the ways in which oral manifestations can be used as predictors of disease progression; on the impact of the limited availability of health care for impoverished families who are disproportionately affected by HIV infection; and on supportive care and its impact on infected children's quality of life.
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