Decline in the rate of oral opportunistic infections following introduction of highly active antiretroviral therapy

Abstract

In recent years the management of human immunodeficiency virus (HIV)-positive individuals has been based on highly active antiretroviral therapy (HAART) comprising a combination of nucleoside analogues or the combination of these agents with protease inhibitors. The aim of the present study was to describe the prevalence of oral lesions in a cohort of 103 HIV-seropositive patients on HAART, to compare these data with the prevalence of lesions prior to HAART and to correlate these finding with the immunologic data. A total of 103 HIV-seropositive patients on HAART were selected. Oral lesions associated with HIV infection and immunological parameters were registered. On re-examination 6 months after the first evaluation, 61/103 patients were available. Comparing the prevalence of oral lesions before and after the onset of HAART, the number of oral lesions was significantly lower (P=0.001). The number of CD4+ cells increased and the viral load decreased significantly after initiation of HAART (P=0.001 and P= 0.0001). On re-examination 6 months later, the prevalence of lesions again decreased significantly (P=0.001). The immunological benefits of HAART may prevent HIV-associated oral lesions in patients with advanced HIV disease. Our results showed that oral manifestations decrease on HAART, but in four patients the immunological effects of therapy did not provide sufficient protection against human papillomavirus (HPV)induced lesions.

Impact of highly active antiretroviral therapy (HAART) on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil

“…These findings are in agreement with various studies that have linked the of use of HAART therapy to a decline in opportunistic infections in adult HIV-infected patients 7,18,19,20,21 . In an investigation realized by Schmidt-Westhausen et al 21 in 2000, the prevalence of oral opportunistic infections associated with HIV was analyzed before and after beginning HAART. A statistically significant reduction in oral candidiasis was observed, with a pre-HAART incidence rate of 66%, contrasting with one of 5.8% after this therapy was introduced.…”

Immunological and clinical progress of HIV-infected patients on highly active antiretroviral therapy in north west Ethiopia

“…The introduction of highly active antiretroviral therapy (HAART) in 1997 has markedly improved the length of survival and the morbidity of HIV-infected patients through the improvement of the immunodeficiency caused by HIV infection (2)(3)(4)(5)(6)(7)(8)(9)(10). In recent years, the management of human immunodeficiency virus positive individuals has been based on HAART comprising a combination of nucleoside analogue reverse transcriptase inhibitors and at least one protease inhibitor and/or one non-nucleoside analogue reverse transcriptase inhibitor (11).…”

Oral medicine 11. Rode en blauwe veranderingen van het mondslijmvlies

“…Het kaposisarcoom was een zeldzaam vasculair neoplasma, die begin jaren '80 van de vorige eeuw met de opkomst van aids veel vaker voorkwam bij individuen die geïnfecteerd waren met hiv (human immu nodeficiency virus). De prevalentie van het aidsgerelateerde kaposisarcoom is met de introductie van de 'highly active antiretroviral therapy' (HAART) in de jaren '90 weer gedaald (Schmidt-Westhausen et al, 2000;Eyeson et al, 2002 Behandeling is symptomatisch of om eventuele esthetische redenen en kan bestaan uit excisie, intralesionale injectie met een chemotherapeuticum of lokale radiatie (Becker en Bottke, 2006;Fatahzedeh en Schwartz, 2013).…”