Oral manifestations of human immunodeficiency virus/acquired immunodeficiency syndrome and their correlation with HAART and CD4+ T-cell count. A systematic review.

Abstract

Event Abstract Back to Event Oral manifestations of human immunodeficiency virus/acquired immunodeficiency syndrome and their correlation with HAART and CD4+ T-cell count. A systematic review. Luca Oberti1*, Federica Gabrione1, Annalisa Palmieri2, Alberta Lucchese3, Francesco Carinci2 and Dorina Lauritano1 1 Università degli studi di Milano Bicocca, Department of Medicine and Surgery, Italy 2 University of Ferrara, Department of Morphology, Experimental Medicine and Surgery, Italy 3 Università degli Studi della Campania 'Luigi Vanvitelli' Naples, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Italy Aim. This review aims to address oral manifestations of human immunodeficiency virus/acquired immunodeficiency syndrome and their correlation with Highly Active Antiretroviral Therapy (HAART) and CD4+ T-cell count. Materials and Methods. We reviewed 35 out of 179 articles on Medline sorted by the relevance option. The main purpose of this paper is to up-date of the main HIV-related oral manifestations and their correlation with HAART and CD4+ T-cell count. We considered 179 bibliographic references, from which we eliminated all case reports, all observational studies, and all the basic researches duplicating findings already published, with the aim of producing a review up-to-date as possible, and succinctly set out an overview of the rationale of HIV-related oral manifestations and their correlation with HAART and CD4+ T-cell count correlation between. We limited our review to 30 articles. Results. Oral candidiasis, oral hairy leukoplakia, Kaposi's sarcoma, and HSV infection are the lesions which have seen the major drop in their incidence after the HAART introduction. Furthermore, the increase in CD4+ T-cell count is not significantly correlated to the incidence decrease of every kind of oral lesions, but it is statistically significant only in relation to oral candidiasis (p-value < 0.001). Discussion. Oral lesions are important signs of immunodepression and with the introduction of HAART their incidence is strongly decreased, in particular in urban areas. Nevertheless, developing countries still have a high prevalence of these manifestations, because of the persistence of many risk factor, like the difficult in accessing to treatment, the poor oral hygiene, the low socioeconomic status and the late diagnosis. Especially in these areas of the world the simple evaluation of the oral lesions, of their condition and of their progression could represent a valid prognostic tool and could also allow to intercept patients still not diagnosed.