Oral Kaposi Research Articles

Factors affecting Kaposi’s sarcoma-associated herpesvirus transmission in rural Ugandan households, a longitudinal study

BackgroundWe report the impact of HIV infection within a household on oral Kaposi’s sarcoma-associated herpesvirus (KSHV) shedding.MethodsWe enrolled 469 individuals from 90 households. Mouthwash rinse samples collected at three monthly visits were analyzed for KSHV DNA using quantitative polymerase chain reaction (qPCR). Generalized linear mixed effects logistic models were applied to analyze factors associated with KSHV ever shedding, and among shedders, always versus intermittent shedding. Linear mixed effects models were applied to models of KSHV viral loads. Intraclass correlation coefficients (ICCs) were calculated to assess the contribution of household-level factors to variations in shedding probabilities. Hotspot analyses of geospatial feature clusters were calculated using Getis-Ord Gi* statistic and visualized using inverse distance weighted interpolation.ResultsAnalyses included 340 KSHV seropositive individuals, aged 3 + years, with qPCR results from 89 households. Forty households had 1 + persons living with HIV (PLWH), while 49 had none. Among participants, 149(44%) were KSHV ever shedders. Of 140 who shed KSHV at two or more visits, 34(24%) were always shedders. Increasing number of KSHV seropositive household members was significantly associated with ever shedding [Odds ratio(OR) (95% Confidence Interval(95%CI)):1.14(1.03,1.26);p = 0.013]. Among KSHV shedders, a statistically significant age-related trend was identified with 10–19 years being more likely to be always shedders (type III test p = 0.039) and to have higher viral loads (type III test p = 0.027). In addition, higher viral loads were significantly associated with increasing number of household members [coefficient(95%CI):0.06(0.01,0.12);p = 0.042], increasing number of KSHV seropositive members [coefficient(95%CI):0.08(0.01,0.15);p = 0.021], and living in households with 1 + PLWH [coefficient(95%CI):0.51(0.04,0.98);p = 0.033]. Always shedders exhibited higher viral loads than intermittent shedders [coefficient(95%CI):1.62(1.19,2.05);p < 0.001], and viral loads increased with the number of visits where KSHV DNA was detected in saliva (type III test p < 0.001). Household-level factors attributed for 19% of the variability in KSHV shedding (ICC:0.191;p = 0.010). Geospatial analysis indicated overlapping hotspots of households with more KSHV seropositive individuals and KSHV shedders, distinct from areas where PLWH were clustered.DiscussionKSHV oral shedding is influenced by multiple factors at the individual, household, and regional levels. To mitigate ongoing KSHV transmission a comprehensive understanding of factors contributing to oral KSHV reactivation and transmission within households is needed.

Highly Heterogeneous Kaposi Sarcoma-Associated Herpesvirus Oral Shedding Kinetics Among People With and Without Kaposi Sarcoma and Human Immunodeficiency Virus Coinfection.

An improved understanding of oral Kaposi sarcoma-associated herpesvirus (KSHV) viral dynamics could provide insights into transmission risk and guide vaccine development. We evaluated KSHV oral shedding dynamics in Ugandan adults stratified by Kaposi sarcoma (KS) and human immunodeficiency virus (HIV) status. Participants were followed for ≥4 weeks, with daily home oral swab collection to quantify KSHV using polymerase chain reaction. Shedding rates were defined by number of days with KSHV DNA detected divided by total days with swabs and compared by group using hurdle models. Two hundred ninety-five participants were enrolled; median age was 35 years (range, 18-71 years), and 134 (45%) were male. KSHV was detected more frequently among participants with KS (HIV positive [HIV+]/KS+, 56/76 [74%]; HIV negative [HIV-]/KS+, 9/18 [50%]) than those without KS (HIV+/KS-, 36/125 [29%]; HIV-/KS-, 16/76 [21%]); odds of shedding did not differ significantly by HIV status. Among participants with KSHV detected, shedding rates did not differ significantly by group. Median per-participant viral loads among positive samples were lowest in HIV+/KS+ (3.1 log10 copies/mL) and HIV-/KS+ (3.3 log10 copies/mL) participants relative to HIV+/KS- (3.8 log10 copies/mL) and HIV-/KS- (4.0 log10 copies/mL) participants. All groups had participants with low viral load intermittent shedding and participants with high viral load persistent shedding. Within each group, individual KSHV shedding rate positively correlated with median KSHV log10 copies/mL, and episode duration positively correlated with peak viral load. Oral KSHV shedding is highly heterogeneous across Ugandan adults with and without KS and HIV. Persistent shedding is associated with higher median viral loads regardless of HIV and KS status.

Factors affecting Kaposi's sarcoma-associated herpesvirus transmission in rural Ugandan households, a longitudinal study.

We report the impact of HIV infection within a household on oral Kaposi's sarcoma-associated herpesvirus (KSHV) shedding. We enrolled 469 individuals from 90 households. Mouthwash rinse samples collected at three monthly visits, were analyzed for KSHV DNA using quantitative polymerase chain reaction (qPCR). Generalized linear mixed effects logistic models were applied to analyze factors associated with KSHV ever shedding, and among shedders, always versus intermittent shedding. Linear mixed effects models were applied to models of KSHV viral loads. Intraclass correlation coefficients (ICCs) were calculated to assess the contribution of household-level factors to variations in shedding probabilities. Hotspot analyses of geospatial feature clusters were calculated using Getis-Ord Gi* statistic and visualized using inverse distance weighted interpolation. Analyses included 340 KSHV seropositive individuals, aged 3 + years, with qPCR results from 89 households. Forty households had 1 + persons living with HIV (PLWH), while 49 had none. Among participants, 149(44%) were KSHV ever shedders. Of 140 who shed KSHV at two or more visits, 34(24%) were always shedders. Increasing number of KSHV seropositive household members was significantly associated with ever shedding [Odds ratio(OR) (95% Confidence Interval(95%CI)):1.14(1.03,1.26);p = 0.013]. Among KSHV shedders, a statistically significant age-related trend was identified with 10-19 years being more likely to be always shedders (type III test p = 0.039) and to have higher viral loads (type III test p = 0.027). In addition, higher viral loads were significantly associated with increasing number of household members [coefficient(95%CI):0.06(0.01,0.12);p = 0.042], increasing number of KSHV seropositive members [coefficient(95%CI):0.08(0.01,0.15);p = 0.021], and living in households with 1 + PLWH [coefficient(95%CI):0.51(0.04,0.98);p = 0.033]. Always shedders exhibited higher viral loads than intermittent shedders [coefficient(95%CI):1.62(1.19,2.05);p < 0.001], and viral loads increased with the number of visits where KSHV DNA was detected in saliva (type III test p < 0.001). Household-level factors attributed for 19% of the variability in KSHV shedding (ICC:0.191;p = 0.010). Geospatial analysis indicated overlapping hotspots of households with more KSHV seropositive individuals and KSHV shedders, distinct from areas where PLWH were clustered. KSHV oral shedding is influenced by multiple factors at the individual, household, and regional levels. To mitigate ongoing KSHV transmission a comprehensive understanding of factors contributing to oral KSHV reactivation and transmission within households is needed.

Evaluation of therapeutic response to algorithm assisted improvement of oral mucosa damage in male AIDS patients

HIV/AIDS is now the biggest cause of mortality in Africa and the fourth highest cause of death globally. Half or more of HIV-infected individuals and as many as 80% of AIDS patients develop oral lesions. People living with HIV/AIDS may benefit from early testing, diagnosis, and treatment if oral lesions are detected, as they are the initial clinical characteristics of the infection and strong indicators of immunodeficiency. Oral candidiasis (OPC), oral hairy leukoplakia (OHL), oral Kaposi’s sarcoma (OKS), and HIV-associated periodontal diseases were the subjects of this comprehensive review designed to assess the available data for the management of these and other common oral mucosa damage that are linked to HIV. Further exacerbating the condition are host variables such as xerostomia, smoking, dental caries, oral prosthesis, diabetes, and cancer treatments. A separate portion of this Worldwide Workshop discusses the treatment of salivary gland illness linked with HIV. Oral mucosa injury in AIDS patients does not have a reliable diagnostic approach. Improving the early diagnosis of Oral Mucosa damage in male AIDS patients was the primary goal of this work, which sought to construct an Artificial Intelligence (AI) diagnostic model with high sensitivity. To demonstrate a Gradient Boosting Regression (GBR) based method for assessing the efficacy of treatments for oral mucosa damage in AIDS patients. Both investigation and diagnostic applications may benefit from this predictor. Results show that, compared to existing models, the suggested AI and GBR methods can accurately predict oral mucosa deterioration in AIDS patients. This study significantly contributes to the profession by improving the accuracy of diagnoses and providing useful information for treatment options.

BI13 (P99) Skin disease in people living with HIV in the UK: a retrospective analysis

Abstract The spectrum of skin disease associated with advanced HIV infection is well described and can vary between countries, potentially as a result of genetic differences and access to antiretroviral treatment (ART). Effective ART has modified the skin manifestations of HIV in the modern era. The aim of this study was to characterize the profile of skin disease in a UK-based population of people living with HIV (PLHIV). A retrospective review of inpatient admission records was conducted for all patients admitted to a tertiary hospital between June 2020 and October 2022. Data were collected using a standardized data extraction form in Microsoft Excel. Descriptive analysis was undertaken within Excel. Ninety-seven patients were identified (median age 55 years), of whom 82 (85%) were male. Median duration of HIV infection was 15 years [interquartile range (IQR) 8.66–19.58], with a median duration on ART of 9 years (IQR 3–16). Fourteen patients were ART naïve and were diagnosed as being HIV positive on admission. Median CD4 count at presentation was 351 × 106 cells L–1 (IQR 136–579). Fifty-five patients presented with a single dermatological condition, 30 presented with two and 10 presented with three. Of the conditions identified, 48% were skin infections, 18% were skin tumours, 10% were inflammatory dermatoses and 2.8% were drug reactions. In the remaining 21%, the diagnosis was unknown; this included rashes (44%), skin lesions (33%) and ulcers (22%). The most common dermatological condition identified was cellulitis (n = 18; 19%). Of the infections seen, 46% were primary bacterial infections, 27% were primary viral infections, 22% were primary fungal, 3% were primary parasitic and 1% were systemic bacterial infection with skin involvement. Ten per cent of patients presented with Kaposi sarcoma, an AIDS-defining illness. Of the 97 patients, 27% presented with advanced HIV (CD4 &amp;lt; 200 × 106 cells L–1). The most common conditions in this group were oral candidiasis (30%), cellulitis (15%), seborrhoeic dermatitis (15%) and Kaposi sarcoma (15%). Bacterial skin infections were the most common dermatological conditions overall, while oral candidiasis was the most common condition in those with advanced HIV. The causes of almost one-quarter of dermatological presentations were unknown during inpatient admission, highlighting the importance of expert dermatological input. Further work is needed to validate these findings in a larger population of PLHIV, including those managed in an outpatient setting.

P99 Skin disease in people living with HIV in the UK: a retrospective analysis

Abstract The spectrum of skin disease associated with advanced HIV infection is well described and can vary between countries, potentially as a result of genetic differences and access to antiretroviral treatment (ART). Effective ART has modified the skin manifestations of HIV in the modern era. The aim of this study was to characterize the profile of skin disease in a UK-based population of people living with HIV (PLHIV). A retrospective review of inpatient admission records was conducted of all patients admitted to a tertiary hospital between June 2020 and October 2022. Data were collected using a standardized data extraction form in Microsoft Excel. Descriptive analysis was undertaken within Excel. Ninety-seven patients were identified (median age 55 years), of whom 82 (85%) were male. Median duration of HIV infection was 15 years [interquartile range (IQR) 8.66–19.58], with a median duration on ART of 9 years (IQR 3–16). Fourteen patients were ART naïve and were diagnosed as being HIV positive on admission. Median CD4 count at presentation was 351 × 106 cells L−1 (IQR 136–579). Fifty-five patients presented with a single dermatological condition, 30 presented with 2 and 10 presented with 3. Of the conditions identified, 48% were skin infections, 18% were skin tumours, 10% were inflammatory dermatoses and 2.8% were drug reactions. In the remaining 21%, the diagnosis was unknown; this included rashes (44%), skin lesions (33%) and ulcers (22%). The most common dermatological condition identified was cellulitis (n = 18; 19%). Of the infections seen, 46% were primary bacterial infections, 27% were primary viral infections, 22% were primary fungal, 3% were primary parasitic and 1% were systemic bacterial infection with skin involvement. Ten per cent of patients presented with Kaposi sarcoma, an AIDS-defining illness. Of the 97 patients, 27% presented with advanced HIV (CD4 &amp;lt; 200 × 106 cells L−1). The most common conditions in this group were oral candidiasis (30%), cellulitis (15%), seborrhoeic dermatitis (15%) and Kaposi sarcoma (15%). Bacterial skin infections were the most common dermatological conditions overall, while oral candidiasis was the most common condition in those with advanced HIV. The causes of almost one-quarter of dermatological presentations were unknown during inpatient admission, highlighting the importance of expert dermatological input. Further work is needed to validate these findings in a larger population of PLHIV, including those managed in an outpatient setting.

Oral, conjunctival and Auricular Kaposi’s sarcoma in a HIV-negative patient : an unusual presentation

Kaposi’s sarcoma is an unusual multicentric malignant neoplastic disease, that characterized by the proliferation of spindle-shaped cells. This tumor is habitually involving in the skin of the lower extremities. However, it is rarely developing in the mucosa or skin of the head and neck. Herein, we report an uncommon presentation of Kaposi sarcoma affecting auricle,oral and ocula rmucosa in an immunocompetent patient. The diagnosis was made on clinical and histopathological finding.

Prevalence of oral lesions in patients with AIDS: a systematic review and meta-analysis.

Background Oral lesions are considered to be early clinical signs which may predict the progression of patients with acquired immune deficiency syndrome (AIDS). Due to the lack of a comprehensive study that includes oral lesions in people with AIDS, the global prevalence of oral lesions in people with AIDS was estimated by combining preliminary studies' results using meta-analysis.Material and methods Databases including PubMed, Science Direct and Scopus were searched using keywords as 'HIV', 'AIDS', 'oral candidiasis', 'Kaposi Sarcoma', 'LinearGingival Erythema' and OR operators, AND and NOT. After the elimination of duplicate documents, articles that met the inclusion criteria were selected. Quality assessment was performed based on the Newcastle-Ottawa Scale. After combining the results of preliminary studies, an overall estimate of each lesion was reported. Ninety-five studies met the criteria for inclusion in this meta-analysis.Results The global prevalence of 21 oral lesions in HIV-infected patients was estimated. The overall prevalence of oral candidiasis, pseudomembranous candidiasis, oral hairy leukoplakia, Kaposi sarcoma and erythematous candidiasis was as follows: 35% (95% CI: 28-42), 19% (95% CI: 15-22), 12% (95% CI: 11-14), 5% (95% CI: 4-6) and 18% (95% CI: 14-22).Conclusion The present meta-analysis showed that oral lesions have a high prevalence in patients with AIDS. Dentists should consider that the clinical appearance of the oral cavity reflects the overall systemic health of the patient. As such, oral lesions may be linked to underlying immunosuppression caused by AIDS.

Change in profile of cutaneous manifestations of HIV after the advent of antiretroviral therapy: a retrospective analysis

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To date, there has been no study conducted in Zambia to determine the prevalence of mucocutaneous conditions among HIV positive patients on antiretroviral therapy.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The aim of the study was to determine the differences in cutaneous manifestations of HIV between HIV positive adult patients on antiretroviral therapy and antiretroviral naïve patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 143 adult HIV/AIDS patients with dermatological manifestations, and fulfilling inclusion criteria, were included. Among the 58 patients on antiretroviral therapy, the most common dermatoses were hyper-pigmentation (18.97%), fungal dermatitis (17.24%) genital herpes (8.62%), papular pruritic eruption (8.62%), oral candidiasis (8.62%) and Kaposi’s sarcoma (6.9%). The most common dermatoses among the 85 antiretroviral naive patients were oral candidiasis (34.12%), herpes Zoster (17.65%), hyper pigmentation (8.24%), eosinophillic folliculitis (7.06%), abscesses (5.88%), herpes labialis (4.71%) and Kaposi's sarcoma (4.71%). Among patients in Stage III of HIV infection, the proportion of patients with infectious dermatoses was significantly greater than the proportion of patients with non-infectious dermatoses (47.5% versus 28.6%; p=0.036).The odds of having an infectious dermatosis were 28% lower for patients on antiretroviral therapy as compared to antiretroviral naive patients (p=0.001).&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There is a changing profile of muco-cutaneous conditions in HIV infected patients. Infectious dermatoses such as oral candidiasis and Herpes Zoster infections occur more frequently in antiretroviral naïve patients, as compared to patients on ART. Prevention of infectious dermatological conditions occurs with the use of ART.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Clinical and Laboratory Profile of People Living with HIV/AIDS with Oral Kaposi Sarcoma.

The aim of this article was to evaluate the clinical and laboratory profile of people with oral Kaposi's sarcoma (KS) associated with AIDS (KS-AIDS), followed-up at a public university hospital in Salvador, Bahia, Brazil, in the past 10 years. We identified patients diagnosed with KS-AIDS, presenting oral manifestation from January 2007 to December 2017. We searched, in the hospital information systems, the patient demographics, diagnostic data, treatment, image studies, and oral photographic records. Of the 39 cases of KS-AIDS identified at the institution, 14 (22.8%) presented oral lesions. There was a predominance of black men, with a mean age of 32.5 years. Most cases (85.1%) manifested signs of KS simultaneously with the diagnosis of HIV infection, with extremely low initial CD4 T cell counts (average of 52.6 cells/mm2) and visceral involvement (64.3%). The palate (32.1%) and gingiva (21.4%) were the most affected oral sites. Histologically, the tumors exhibited proliferation of spindle cells between vascular clefts and extravasated erythrocytes. Oral KS-AIDS was frequent in young black adult men, with severe immunosuppression and high viral load counting, mostly with lesions manifested in the same period of diagnosis of infection by the HIV.

Oral Kaposi’s Sarcoma: A Case Report and Literature Review on Treatment Management

Background: Kaposi’s sarcoma is a common malignancy in HIV patients. Oral manifestation of AIDS-associated Kaposi’s sarcoma occurs in up to 65% of HIV/AIDS patients and is a poor prognostic factor. We report the case of a patient with a progressive bulky manifestation of oral Kaposi’s sarcoma. Case Presentation: A 48-year-old male presented with dysphagia due to progressive indolent swelling of the palate. Intraoral inspection revealed an uneven, partially ulcerated, livid mass, approximately 5 cm in diameter, extending antero-posteriorly from the superior vestibulum to the soft palate and across the hard palate, thereby overgrowing remaining teeth and the alveolar arch. Serological testing revealed an HIV infection, and further tests showed HHV8-positivity. The patient underwent surgical debulking of the oral lesions and, following complete remission, received full mouth reconstruction with an implant-supported prosthesis. Conclusions: Understanding the relation of HIV and HHV8-infection in terms of disease onset and clinical presentation is important to increase awareness of oral Kaposi’s sarcoma and ensure subsequent appropriate management of affected patients. Clinical staging represents the most important factor for choosing the optimal treatment. The introduction of combined antiretroviral therapy has proven to be efficient in curing oral Kaposi’s sarcoma, while several additional locoregional treatment options, including debulking surgery, may be necessary for symptom relief or to improve cosmesis. Radiotherapy should be applied restrictively due to potentially severe toxic mucosal reactions, whereas additional chemotherapy must be considered in severe cases that present with widespread disseminated disease. A multidisciplinary approach to the treatment of functionally and aesthetically impairing oral Kaposi’s sarcoma is highly recommended.

Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio.

Background Kaposi’s sarcoma (KS) is an uncommon, multifocal and angioproliferative lesion, which demonstrates a poor prognosis. The aim of the present research was to explore the association of HIV viral load, CD4+ and CD8+ counts and the CD4+/CD8+ ratio on the risk of oral Kaposi’s sarcoma (KS) development.Material and Methods A total of 62 patients were retrieved from March 2008 to October 2020 from the files of two oral pathology centres. Clinical, laboratory and follow-up data were retrieved from their medical files. Poisson regression was used to explore the role of history of immunosuppression and its association with oral KS development. A P-value <0.05 was considered significant.Results Sixty-two patients were included in the present study (32 with oral KS and 30 with no presentation of lesions anywhere on the body). Patients with oral KS presented a mean age of 32.6 years, and male patients were more affected. The hard palate (15 cases; 46.8%) was the main anatomical site affected. The lesions were mostly presented as swellings (13 cases; 40.6%) and nodules (12 cases; 37.5%). Systemic manifestations were also observed, including candidiasis (4 cases; 12.5%), bacterial infection (3 cases; 9.3%), tuberculosis (3 cases; 9.3%), herpes simplex (3 cases; 9.3%) and pneumonia (3 cases; 9.3%). A significant correlation was observed between HIV viral load, CD4+ count and the CD4+/CD8+ ratio with oral KS development.Conclusions HIV viral load, CD4+ count and the CD4+/CD8+ ratio are associated with oral KS development. Key words:Cancer, oral, Kaposi’s sarcoma, diagnostic.

Diode laser as local treatment for oral Kaposi's sarcoma in HIV young patient: a case report

Introduction: Kaposi's sarcoma (KS) is a malignant mucocutaneous neoplasm caused by human herpesvirus 8 (HHV-8). Four types of KS exist and, in each of them, the patient could develop skin and visceral lesions. Surgical excision, radiotherapy, intralesional chemotherapy and systemic chemotherapy are widely accepted as treatment options. Observation: The aim of this paper is to present diode laser as minimally invasive procedure in management of oral KS. We report here a case of multiple oral lesions of acquired immunodeficiency syndrome (AIDS)-associated KS, which has been solely treated with diode laser. Discussion: There is no bibliography on local treatment of oral KS with diode laser and this clinical case appears to be the first regarding this technique. Conclusion: This conservative approach, in association with highly active antiretroviral therapy (HAART), is safe and effective, shows fewer side effects than chemotherapy, radiotherapy and surgical excision and may be evaluated as potential treatment for oral KS.

A study on otorhinolaryngologic manifestations in human immunodeficiency virus infected patients

&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Background: &lt;/span&gt;&lt;/strong&gt;The main aim of this study was to find out the ear, nose, and throat (ENT) manifestations in a selected regional population of 100 HIV infected patients, to identify the commoner ENT manifestations among them and to make these manifestations, a guide for regional ENT surgeons, to diagnose HIV/AIDS patients early and to treat them accordingly.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Methods: &lt;/span&gt;&lt;/strong&gt;The study was a prospective study which was conducted for a period of five years which included 100 HIV seropositive patients, among the patients attending the Outpatient Department of the Otorhinolaryngology and anti-retroviral therapy centre across Government Hospitals in Tamil Nadu according to our inclusion or exclusion criteria. Detailed ENT clinical examination as well as laboratory investigations were carried out to evaluate the nature of ENT presentations of HIV infection. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Results: &lt;/span&gt;&lt;/strong&gt;Out of the 100 HIV positive patients, who had some form of ENT symptoms, the most common ENT manifestation in HIV/AIDS was oral candidiasis (40%) followed by cervical lymphadenopathy (30%). Other common manifestations are oral herpes simplex and sensorineural hearing loss. Less common manifestations are chronic sinusitis, tuberculous laryngitis, chronic otitis media, oral hairy leukoplakia, nasal polyps and Kaposi’s sarcoma. Oral candidiasis, chronic/recurrent mucocutaneous herpes simplex, oral hairy leukoplakia and Kaposi’s sarcoma are the AIDS defining illnesses. Oral hairy leukoplakia, is pathognomonic of HIV infection.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Conclusions: &lt;/span&gt;&lt;/strong&gt;These manifestations help ENT surgeons, to recognize HIV/AIDS patients from the specific ENT lesions occurring in them, for early diagnosis and subsequent treatment.&lt;/p&gt;

ACQUIRED IMMUNODEFICIENCY SYNDROME ORAL MANIFESTATIONS: A CASE SERIES

Acquired immunodeficiency syndrome (AIDS) is a chronic systemic disease. This condition can be manifested if the patient is infected by the human immunodeficiency virus (HIV). This virus attacks the immune system and interferes in the host resistance. Consequently, infected organisms become immunosuppressed and susceptible to acquiring other opportunistic infections and injuries. The HIV-related diseases most frequent in the oral cavity are candidiasis, gingivitis, oral hairy leukoplakia, herpes simplex, and Kaposi sarcoma. The objective of this study is to report 4 clinical cases of patients with the oral disorders listed above. AIDS oral manifestations may represent the first clinical signs of HIV infection. Therefore, knowledge of oral lesions associated with HIV infection is extremely important for the oral surgeon. Based on this, the health professional can make the HIV diagnosis of this complex systemic disease, in some cases not previously diagnosed.

Distribution of Dendritic Cells in AIDS-Associated Oral Kaposi's Sarcoma.

The aim of this study was to determine if the distribution of Langerhans cells (LC) and interstitial dendritic cells (IDC) is altered in AIDS-associated oral Kaposi's sarcoma when compared to HIV-negative highly vascular oral lesions. Fifty-one cases of AIDS-associated oral Kaposi's sarcoma and 20 of highly vascular oral lesions were retrospectively retrieved. All cases of Kaposi's sarcoma were confirmed with immunoreactions against CD34 and HHV-8. Clinical data regarding sex, age and lesions location were obtained from pathology reports. Immunohistochemistry against CD207 (immature dendritic cells) and CD83 (mature dendritic cells) were done. LC were in the epithelium and IDC in the stroma. CD207+ cells predominated in the epithelium of the lesions, whereas CD83+ cells predominated in their stromal compartment. Kaposi's sarcoma had a lower CD207+ immature LC count (p=0.02) and an increased CD207+ IDC than highly vascular oral lesions (p<0.001). Moreover, Kaposi's sarcoma also showed an increased number of mature CD83+ IDC than highly vascular oral lesions (p<0.001). There were significant alterations in the distribution of LC and IDC in AIDS-associated Kaposi's sarcoma when compared to HIV-negative vascular oral lesions, suggesting that changes in their concentrations may play a role in the pathogenesis of Kaposi's sarcoma.

&lt;p&gt;Assessing the levels of HIV-related knowledge and attitudes toward HIV-infected patients among undergraduate dental students: a cross-sectional study&lt;/p&gt;

PurposeWorldwide, in the last decade, the numbers of new HIV infections and AIDS-related deaths have drastically decreased. Despite that, around 18 million infected individuals receive antiretroviral therapy and thus tend to live longer. This cross-sectional study was conducted to assess the level of HIV-related knowledge among undergraduate dental students at Ain Shams University (ASU) in Cairo, Egypt and to determine their attitudes toward treating HIV-positive patients.MethodsThe study sample included 247 undergraduate dental students of third, fourth, and fifth academic years at the Faculty of Dentistry, ASU who were randomly selected to participate in this survey. Data were collected using a self-administrated anonymous questionnaire. Chi square and ANOVA tests were used to measure differences in the level of knowledge and attitudes among students of the 3 years. Multiple linear regression analysis was performed with 95% confidence interval.ResultsWithin the students’ population, around 94% incorrectly considered dentists to be at high risk of acquiring HIV infection and 47% believed that saliva is a vehicle for its transmission. Moreover, the majority of students were unaware of the association between HIV and common oral manifestations such as oral candida, Kaposi sarcoma, and leukoplakia. Although 69% of the students were willing to deliver oral care to people living with HIV (PLHIV), only 33% perceived themselves knowledgeable enough to do so.ConclusionDental students were not adequately prepared to recognize and manage HIV-positive individuals. Thus, better education and training are required to raise their levels of HIV-related knowledge and enhance their capabilities to treat PLHIV.

Oral Kaposi's Sarcoma: Multiple Presentation in an HIV Seropositive Patient

Oral Kaposi's Sarcoma: Multiple Presentation in an HIV Seropositive Patient

A case of extensive oral kaposi's sarcoma in a patient with undiagnosed HIV infection

Abstract: Kaposi's sarcoma (KS) is a multifocal soft tissue tumour estimated to affect up to 1 in 20 HIV-infected individuals. Oral involvement is commonly the initial presentation, making it important that oral health providers are able to recognize oral disease in all stages of progression. Its various clinical stages (patch, plaque, nodular) can often mimic other benign lesions, such as pyogenic granuloma, potentially leading to misdiagnosis. This article aims to help improve recognition of KS amongst oral health professionals by raising awareness of its oral features. It is hoped that this will aid in early diagnosis and improved outcomes for patients.CPD/Clinical Relevance: Kaposi's sarcoma is a common tumour amongst HIV-infected individuals often presenting with oral involvement. Recognition of the tumour, especially at the early stages, allows for early diagnosis and treatment, helping to improve patient prognosis.

Pathology of Candida infection in oral HIV-associated Kaposi sarcoma: A descriptive study

Pathology of Candida infection in oral HIV-associated Kaposi sarcoma: A descriptive study