5 Things to Look for When Caring for Patients with HIV

Oral infections are common in patients with human immunodeficiency virus (HIV), as the disease weakens the immune system, making it harder to fight infection. Early diagnosis is essential for successful management of HIV. For this reason, clinicians must be aware of oral manifestations that may be linked to HIV infection. Here are 5 things to look for when caring for patients with HIV.

1. ORAL HAIRY LEUKOPLAKIA

This oral lesion is white corrugated in appearance and is seen on the lateral borders of the tongue. Oral hairy leukoplakia is common in patients with HIV, as it often manifests in immune-compromised people. This infection can also serve as a predictor of advancing disease in people with untreated HIV.

2. PERIODONTITIS

Patients’ CD4 counts must be considered when developing treatment plans for individuals with HIV, as these numbers help to determine their ability to heal from periodontal procedures. The dental office should have a patient’s CD4, or T cell count and viral load on file. Most patients have these labs checked every 6 months. Patients with a CD4 count ofl ess than 300 cells/mm will require additional labs (see table 3 in this story).

3. KAPOSI SARCOMA

This rare cancer is seen in patients with HIV in the form of red, purple, or dark lesions. This cancer is strongly associated with HIV.

4. CANDIDIASIS

Both erythematous candidiasis—red and flat in appearance—and pseudomembranous candidiasis—white plaques on the tongue or oral mucosa—manifest in patients with HIV. Because oral hygiene plays a role in candidiasis, patients should be reminded of the importance of practicing good oral hygiene.

5. MOUTH PAIN

Patients with HIV may present with mouth sores or xerostomia caused by medication use that cause pain when eating, drinking, or swallowing. Clinicians can help patients manage some of these symptoms through a variety of over-the-counter and prescription options.

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