HIV/AIDS and the Periodontium – Review Flashcards

30 Question-and-Answer style flashcards summarising key facts on HIV/AIDS epidemiology, pathophysiology, classification, oral lesions, periodontal manifestations, diagnostics, and management.

In what year was the term “AIDS” first used?

1984

Approximately how many people worldwide were living with HIV in 2012?

About 35.3 million

Which world region accounted for roughly 68 % of all HIV cases in 2010?

Sub-Saharan Africa

Name the two envelope glycoproteins that allow HIV to bind to CD4 receptors.

gp120 and gp41

Which HIV core protein forms the capsid that encloses viral enzymes and RNA?

p24

List the four tissues that comprise the periodontium.

Cementum, periodontal ligament (PDL), alveolar bone, and gingiva

Why is knowledge of periodontal HIV manifestations important for dentists?

Because periodontal lesions may be the first sign of HIV infection, enabling early diagnosis and limiting disease spread.

WHO Clinical Stage 1 HIV disease is typically characterised by what key feature?

Asymptomatic infection or generalized lymphadenopathy

Give two examples of conditions seen in WHO Clinical Stage 2 HIV disease.

Unexplained weight loss <10 %, recurrent respiratory infections, herpes zoster, angular cheilitis, or recurrent oral ulcers.

At what CD4 count does the CDC Category A3/B3/C3 classification begin?

Below 200 cells/µL

What type of oral lesions are placed in Group 1 (strongly associated with HIV)?

Candidiasis, oral hairy leukoplakia, specific periodontal diseases (LGE, NUG, NP), Kaposi’s sarcoma, non-Hodgkin’s lymphoma

Define Linear Gingival Erythema (LGE).

A bright red band along the free gingival margin that bleeds easily and is commonly associated with HIV infection.

Which CD4 threshold indicates greatly increased risk for opportunistic infection?

Name two laboratory tests commonly used to screen for or confirm HIV infection.

ELISA and Western blot (confirmatory)

What laboratory method quantitates HIV viral copies per millilitre of blood?

Real-time polymerase chain reaction (RT-PCR) viral load test

Give two first-line systemic antibiotics used in treating HIV-related periodontal infections.

Metronidazole and amoxicillin (or amoxicillin-clavulanate)

Which mouth-rinse agents are recommended for HIV-associated periodontal lesions?

0.12 % chlorhexidine, warm hypertonic saline, or 1.5 % hydrogen peroxide

What is the defining clinical feature of Necrotizing Ulcerative Gingivitis (NUG)?

Necrosis and ulceration of interdental papillae with a white pseudomembrane

List three symptoms of NUG.

Constant pain, halitosis, low-grade fever (others: lymphadenopathy, bleeding)

State one possible outcome if NUG is left untreated.

Spontaneous healing, persistent ulcers with recurrence, or progression to NUP with bone loss

Why is pocket formation usually absent in Necrotizing Ulcerative Periodontitis (NUP)?

Because rapid soft-tissue necrosis destroys attachment before true pocketing can develop.

What CD4 count is commonly seen in HIV patients who present with NUP?

Often <200 cells/µL

Name three predisposing factors for NUP besides HIV infection.

Leukaemia, uncontrolled diabetes, neutropenia/agranulocytosis, malnutrition, smoking, stress, immunosuppressive drugs, genetic predisposition

Which opportunistic neoplasm classically appears on oral gingiva in HIV patients?

Kaposi’s sarcoma

What is the recommended recall interval after initial treatment of HIV-related periodontal lesions?

One week for re-evaluation and fine scaling

List two viral infections classified in Group 2 oral lesions associated with HIV.

Cytomegalovirus (CMV) infection and herpes simplex virus (HSV) infection (also HPV, HZV)

According to the CDC, which category includes oral hairy leukoplakia and oral candidiasis?

Category B

Which enzyme contained in HIV is responsible for converting viral RNA into DNA?

Reverse transcriptase

Why can macrophages act as long-term reservoirs for HIV?

They express CD4 receptors and can harbor proviral DNA for prolonged periods, making eradication difficult.

Name two non-periodontal oral manifestations that may accompany advanced HIV infection.

Aphthous ulceration and non-Hodgkin’s lymphoma (others: Kaposi’s sarcoma, atypical ulcers, deep fungal infections)