Oral manifestations of HIV infection

Objective: To provide a comprehensive, literature-based guide to the diagnosis of and the management and referral of patients with oral diseases associated with human immunodeficiency virus (HIV) infection. Data Sources: The literature was reviewed to identify common oral manifestations of HIV infection, the physical and laboratory findings associated with them, and the therapies used to treat them. The National Library of Medicine's AIDSLINE database was searched using the term ''mouth diseases.'' Additional references were identified from the bibliographies of these articles and related textbooks. Study Selection: English-language abstracts were reviewed to determine each paper's clinical relevance. To be considered clinically relevant, a paper had to describe the physical appearance of oral manifestations, methods used to diagnose oral manifestations, or treatment and referral guidelines. More than 600 abstracts were identified. Data Extraction: After the abstracts were reviewed, articles were selected and were reviewed for possible inclusion. If both of two reviewers agreed that an article was clinically relevant and dealt with conditions that occurred in more than 1% of HIV-infected patients, the article was included. Data Synthesis: 16 conditions that occur in more than 1% of HIV-infected patients were identified. Information on these conditions was collected and sorted into three categories: clinical appearance, diagnostic methods, and treatment. Conclusions: Almost all patients with HIV infection will contract oral diseases. Guidelines for recognizing, diagnosing, and managing these conditions are presented. Most conditions can be treated or alleviated through the combined efforts of the physician and the dentist.