Oral Manifestations in HIV/AIDS – Lecture Review

30 question-and-answer flashcards covering HIV transmission, immunology, CDC staging, and EC-Clearinghouse classifications of adult and paediatric oral lesions.

What infectious agent causes AIDS?

Human Immunodeficiency Virus (HIV).

Which four body fluids are primarily responsible for HIV transmission?

Blood, semen, vaginal secretions, and breast milk.

What is the normal T4 (helper) : T8 (suppressor) lymphocyte ratio in healthy individuals?

Approximately 2 : 1 (about 60 % T-helper to 30 % T-suppressor).

How is the T4:T8 lymphocyte ratio altered in AIDS?

The ratio is reversed (T4 counts fall below T8 counts).

Within what time-frame do more than 50 % of HIV-exposed persons experience acute seroconversion illness?

2 – 6 weeks after exposure.

Name three antibodies that typically appear after HIV seroconversion.

Anti-gag, anti-gp120, and anti-p24 antibodies.

What CD4+ T-lymphocyte count defines CDC Stage 1 HIV infection?

≥ 500 cells/µL (or ≥ 29 % of lymphocytes).

Besides a CD4 count ≥ 500 cells/µL, what other criterion must be met for Stage 1 classification?

No AIDS-defining conditions present.

What CD4+ cell range characterizes CDC Stage 2 HIV infection?

200 – 499 cells/µL (or 14 – 28 % of lymphocytes).

State the laboratory criterion for CDC Stage 3 (AIDS).

CD4+ T-lymphocyte count < 200 cells/µL or < 14 % of lymphocytes, or documentation of an AIDS-defining condition.

If an AIDS-defining condition is documented, does the actual CD4 count still determine staging?

No. Documentation of an AIDS-defining condition automatically places the patient in Stage 3 (AIDS) regardless of CD4 count.

List the two clinical forms of oral candidiasis strongly associated with HIV (Group 1).

Erythematous candidiasis and pseudomembranous candidiasis.

Under which EC-Clearinghouse group is oral hairy leukoplakia classified?

Group 1 – lesions strongly associated with HIV infection.

Which three periodontal diseases are included in Group 1 lesions?

Linear gingival erythema, necrotizing (ulcerative) gingivitis, and necrotizing (ulcerative) periodontitis.

Name the two neoplasms listed in Group 1 lesions strongly associated with HIV.

Kaposi’s sarcoma and non-Hodgkin’s lymphoma.

Give two bacterial infections listed as Group 2 lesions less commonly associated with HIV.

Mycobacterium avium-intracellulare and Mycobacterium tuberculosis.

What are two salivary-gland-related manifestations in Group 2 lesions?

Dry mouth due to decreased salivary flow and unilateral or bilateral swelling of major salivary glands.

Which virus causes the warty-like oral lesions (condyloma, verruca) grouped under Group 2?

Human papillomavirus (HPV).

Reactivation of which virus leads to oral herpes zoster, classified in Group 2?

Varicella-zoster virus (VZV).

Name two fungal infections (other than candidiasis) listed among Group 3 lesions in adults.

Cryptococcus neoformans and Histoplasma capsulatum.

Give two neurological disturbances included in Group 3 lesions.

Facial palsy and trigeminal neuralgia.

Which consensus classification (year and author) groups oral lesions into three HIV-associated categories?

The 1992 EC-Clearinghouse / WHO consensus classification.

Which three forms of candidiasis are common Group 1 lesions in paediatric HIV infection?

Erythematous candidiasis, pseudomembranous candidiasis, and angular cheilitis.

Which viral infection is listed in Group 1 paediatric lesions alongside candidiasis?

Herpes simplex virus infection.

What salivary-gland manifestation is included in Group 1 paediatric lesions?

Parotid enlargement.

List the three necrotizing periodontal conditions in Group 2 paediatric lesions.

Necrotizing (ulcerative) gingivitis, necrotizing (ulcerative) periodontitis, and necrotizing (ulcerative) stomatitis.

Name a dermatologic condition included in Group 2 paediatric lesions.

Seborrheic dermatitis.

Which paediatric lesion group is described as “strongly associated with HIV but rare in children”?

Group 3.

Identify the two neoplasms found in paediatric Group 3 lesions.

Kaposi’s sarcoma and non-Hodgkin’s lymphoma.

Why is documenting oral-lesion prevalence in HIV-infected versus HIV-negative populations important?

To distinguish unusual presentations of common endemic diseases from truly new HIV-associated conditions.