Oral manifestations associated with HIV infection

Nokta, Mostafa

doi:10.1007/s11904-008-0002-8

Cited by 63 publications

(58 citation statements)

References 65 publications

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“…In fact, a high prevalence of oral bacterial (e.g., HIV-1 gingivitis and periodontitis), fungal (e.g., pseudomembranous candidiasis), and viral (e.g., oral hairy leukoplakia and Kaposi's sarcoma) coinfections in HIV-1 ϩ patients has been described widely (18,55). Evidence also suggests that periodontal disease, oral candidiasis, and oral hairy leukoplakia positively correlate with higher HIV viral loads (1,2,15,28,59), although the potential for oral pathogens to stimulate latently infected cells and induce HIV-1 reactivation has received little attention (27).…”

mentioning

confidence: 99%

HIV-1 Reactivation Induced by the Periodontal Pathogens Fusobacterium nucleatum and Porphyromonas gingivalis Involves Toll-Like Receptor 4 and 9 Activation in Monocytes/Macrophages

González

Ebersole

et al. 2010

Clin Vaccine Immunol

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Although oral coinfections (e.g., periodontal disease) are highly prevalent in human immunodeficiency virus type 1-positive (HIV-1 ؉ ) patients and appear to positively correlate with viral load levels, the potential for oral bacteria to induce HIV-1 reactivation in latently infected cells has received little attention. We showed that HIV-1 long terminal repeat (LTR) promoter activation can be induced by periodontopathogens in monocytes/ macrophages; nevertheless, the mechanisms involved in this response remain undetermined. Since Toll-like receptor 2 (TLR2), TLR4, and TLR9 activation have been involved in HIV-1 recrudescence, we sought to determine the role of these TLRs in HIV-1 reactivation induced by the periodontal pathogens Fusobacterium nucleatum and Porphyromonas gingivalis using BF24 monocytes/macrophages stably transfected with the HIV-1 promoter driving chloramphenicol acetyltransferase (CAT) expression and THP89GFP cells, a model of HIV-1 latency. We demonstrated that TLR9 activation by F. nucleatum and TLR2 activation by both bacteria appear to be involved in HIV-1 reactivation; however, TLR4 activation had no effect. Moreover, the autocrine activity of tumor necrosis factor alpha (TNF-␣) but not interleukin-1␤ (IL-1␤) produced in response to bacteria could impact viral reactivation. The transcription factors NF-B and Sp1 appear to be positively regulating HIV-1 reactivation induced by these oral pathogens. These results suggest that oral Gram-negative bacteria (F. nucleatum and P. gingivalis) associated with oral and systemic chronic inflammatory disorders enhance HIV-1 reactivation in monocytes/macrophages through TLR2 and TLR9 activation in a mechanism that appears to be transcriptionally regulated. Increased bacterial growth and emergence of these bacteria or their products accompanying chronic oral inflammatory diseases could be risk modifiers for viral replication, systemic immune activation, and AIDS progression in HIV-1 ؉ patients.

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confidence: 99%

HIV-1 Reactivation Induced by the Periodontal Pathogens Fusobacterium nucleatum and Porphyromonas gingivalis Involves Toll-Like Receptor 4 and 9 Activation in Monocytes/Macrophages

González

Ebersole

et al. 2010

Clin Vaccine Immunol

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“…Since the first report in 1984, OHL has been observed mainly in AIDS patients 4,[22][23][24] . However, OHL has been reported in other immunosuppressed patients, including those with ulcerative colitis, pemphigus vulgaris, bullous pemphigoid, Behcet's syndrome, multiple myeloma, and leukemia 5,6,16,17,25 .…”

Section: Discussionmentioning

confidence: 99%

Oral Hairy Leukoplakia Which Occurred as a Presenting Sign of Acute Myeloid Leukemia in a Child

et al. 2010

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Oral hairy leukoplakia (OHL) is caused by the reactivation of a previous Epstein-Barr virus (EBV) infection in the epithelium of the tongue. Most lesions are characterized by corrugated whitish patches on the lateral border of the tongue. It is frequently associated with AIDS, but cases in patients with other immunosuppressed states have also been reported. In leukemia patients, OHL is rarely encountered, and appears only after chemotherapy. We report a case of OHL which occurred as a presenting sign of acute myeloid leukemia (AML) in a previously healthy 15-year-old child. A 15-year-old boy presented with a whitish patch on the left lateral border of the tongue. The biopsy specimen revealed papillomatosis, hyperkeratosis, acanthosis and ballooning degeneration in the stratum spinosum. The patient was EBV seropositive, and PCR analysis of EBV DNA in the lesional tissue was positive. After the diagnosis of OHL in dermatologic department, the patient was referred to pediatrics due to the abnormal peripheral blood smear, and was diagnosed with AML. (Ann Dermatol 22(1) 73∼76, 2010)

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“…WHO proposed the immunological classification on the basis of CD4 count as none or not significant -Group 1 (>500/ ml), mild -Group 2 (350-499/ml), advanced -Group 3 (200-349/ml) and severe -Group 4 (<200/ml). Studying the prevalence of AIDS-related oral lesions in different regions of the world is important as it provides a more thorough description of the epidemic and scientific basis for the appropriate management of the disease by health care workers [8]. Although some lesions such as candidiasis and hairy leukoplakia are considered as prognostic factor of HIV disease, recent data have indicated that concurrent existence of multiple and variable oral lesions is accompanied with poor prognosis of the disease [9].…”

Section: Introductionmentioning

confidence: 99%

“…Most of the patients with oral candidiasis were suffering from severe immunosuppression, and they concluded that candidiasis and gingivitis could be considered as an indicator of the disease progression [4]. The research work conducted by Sud et al and Nokta have also shown an association between low CD4 counts and candidiasis, linear gingival erythema, angular cheilitis, scabies, paronychia, oral pigmentation, diffuse hair loss and other oral symptoms [7,8].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of oral lesions in HIV infected adult population of Mangalore, Karnataka, India

Hegde¹,

Hegde²,

Malhotra³

2012

Biodiscovery

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The aim of this study was to find the prevalence of oral lesions in human immunodeficiency virus (HIV) positive patients and investigate if there was a relationship between oral manifestations and the level of immunosuppression. 125 patients infected with HIV in the age group of 20-40 years were examined for the presence of different oral lesions according to the EEC criterion. The CD4 count, as well as any therapy being instituted was recorded and correlated with the oral manifestations seen.Comparison of common oral lesions present to absent was done by chi square test using linear by linear association. The prevalence of oral lesions among the investigated HIV patients was found to be 71%, with periodontitis -52% and erythematous candidiasis -48% being the most prevalent oral lesions; as well, periodontitis and oral hairy leukoplakia were found to be significantly associated with the immunosuppression in the disease. Thus, oral lesions have been found to be associated with the early manifestation of HIV and a measure of disease severity.

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Oral manifestations associated with HIV infection

Cited by 63 publications

References 65 publications

HIV-1 Reactivation Induced by the Periodontal Pathogens Fusobacterium nucleatum and Porphyromonas gingivalis Involves Toll-Like Receptor 4 and 9 Activation in Monocytes/Macrophages

HIV-1 Reactivation Induced by the Periodontal Pathogens Fusobacterium nucleatum and Porphyromonas gingivalis Involves Toll-Like Receptor 4 and 9 Activation in Monocytes/Macrophages

Oral Hairy Leukoplakia Which Occurred as a Presenting Sign of Acute Myeloid Leukemia in a Child

Prevalence of oral lesions in HIV infected adult population of Mangalore, Karnataka, India

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