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ORAL PROBLEMS RELATED TO HIV INFECTION WITH SPECIAL REFERENCE TO CALIBRATION FOR ORAL LESIONS

Objective

It began in 1986 when the EEC granted funds for a meeting in Copenhagen to produce a classification on the oral lesions associated with the HIV infection.
The objectives of the European Community clearing house were: to establish a classification of the oral lesions related to human immunodeficiency virus (HIV) infection; to produce teaching material for clinicians in the form of posters, slides, etc; to train professionals in the diagnosis of HIV related oral lesions; to write annotated selected bibliographies of the oral lesions; to give lectures and courses on the oral manifestations of HIV infections.
The most commonly found lesions are candidiasis, hairy leukoplakia (HL), periodontal disease and Kaposi's sarcoma. The problem with diagnosing hairy leukoplaskia is its clinical resemblance to certain fungal infections. Persistence of symptoms after antifungal treatment is a strong indication, to be confirmed by histopathological tests including detection of Epstein-Barr viral deoxyribonucleic acid (DNA). The virus has also been detected, however, in samples of normal epithelium.
It is recommended that 42 HIV related oral lesions be divided into 3 groups: lesions strongly associated, less commonly associated, and lesions seen in HIV infection.
Further research is as follows: candidiasis and hairy leukoplakia in relation to HIV infection; further classification and study of HIV related oral ulcerations and periodontal diseases; the predictive value in prognosis and response to treatment of all HIV associated oral lesions.

The following classification of oral lesions associated with HIV infection has been established.

Group I Lesions strongly associated with HIV infection:
Candidiasis (erythematous, hyperplastic, pseudomembranous);
hairy leukoplakia (EBV);
gingivitis in HIV infected persons (necrotizing gingivitis in HIV infected persons, periodontitis in HIV infected persons);
Kaposi's sarcoma;
non hodgkin's lymphoma.

Group II Lesions definitely but less commonly associated with HIV infection:
A typical ulceration;
idiopathic thrombocytopenic purpura;
salivary gland diseases (Dry mouth due to decreased salivary flow rate, Unilateral or bilateral swelling of major salivary glands);
viral infections (Other than EBV) (Cytomegalovirus, herpes simplex virus, human papillomavirus and varicell zoser virus - Herpes zoster, Varicella).

Group III Lesions possibly associated with HIV infection:
Bacterial infections (actinomucosis, enterobacter cloacae, escherichia coli, klebsiella pneumoniae, mycobacterium avium intracellulare, tuberculosis);
cat scratch disease;
ectopic geographic tongue;
epitheloid angiomatosi;
exacerbation of apical periodontitis;
fungal infection other than candidiasis (aspergillus flavus, cryptococcus, geotrichosis, histoplasmosis, mucormycosis);
lymphomatoid granulomatosis;
melanotic hyperpigmentation;
neurologic disturbances (Facial palsy, Trigeminal neuralgia);
osteomyelitis;
sinusitis;
submandibular cellulitis;
squamous cell carcinoma;
toxic epidermolysis.
A new grant made it possible to continue the work in the light of recent advances in the field and expand the work into other fields: teaching materials, teaching, registration forms and ethical aspects.

Funding Scheme

CON - Coordination of research actions

Coordinator

University of Copenhagen
Address
20, Noerre Alle
2200 Copenhagen N
Denmark