International Journal of STD & AIDS > Volume 19, Number 5 > Pp. 305-308

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Original research articles

Oral manifestations after immune reconstitution in HIV patients on HAART

Karem L Ortega DMD PhD ^* , Alejandro Ceballos-Salobreña DMD MD PhD , Luis A Gaitán-Cepeda DMD PhD  and Marina G Magalhães DMD PhD ^*

^* Department of Oral Pathology, Special Care Dentistry Center, University of São Paulo, São Paulo, Brazil; Department of Oral Medicine, University of Granada, Granada, Spain; Department of Oral Pathology, Autonomous National University of Mexico, Mexico

Correspondence to: Dr Karem L Ortega, Faculdade de Odontologia, Disciplina de Patologia Bucal, Universidade de São Paulo, Av. Professor Lineu Prestes, 2227 Cidade Universitaria, 05508-000 São Paulo, SP, Brazil Email: klortega{at}usp.br

In order to verify possible association between immune reconstitution inflammatory syndrome (IRIS) and oral manifestations (OMs), we selected AIDS patients who had low CD4 count before the initiation of highly active antiretroviral therapy (HAART) and who returned three months later for therapy evaluation. The oral lesions observed three months after the initiation of HAART were evaluated and associated with the type of antiretroviral therapy (ART), CD4 count and HIV-RNA load levels (before and three months after HAART initiation). A total of 105 patients matched the selected criteria. Immune reconstitution (IR) was identified in 35.2%. Among these patients, the mean CD4 cell count rose from 105.97 to 330.29 and the mean viral load dropped from 168.005 (log 5.22) to 21.852 (log 4.33). There was no significant difference in age (P = 0.78), sex (P = 0.41) or previous history of ART (P = 0.55) between IR and non-IR patients. In the IR group, the most common OM was parotid enlargement (57.14%) (P = 0.019), whereas in the non-IR group candidiasis (46.15%) was the most common OM. The results of our study suggest that the parotid gland enlargement found in the studied population might be an IRIS event, as it was found in patients with IR three months after the initiation of HAART.

Key Words: AIDS • antiretroviral therapy • HAART, HIV • immune reconstitution • oral manifestations • salivary gland disease

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