Recurrent herpes simplex virus and the acceleration of the wasting syndrome: report of case

Article Abstract:

Herpes simplex virus (HSV) produces small fluid-filled blisters on the skin and mucous membranes. Lesions in and around the mouth are usually an annoyance. For a patient with AIDS (acquired immune deficiency syndrome), HSV may be much more serious. These immune compromised patients have a 50 to 80 percent chance of having antibodies to HSV, compared with an incidence of 20 to 40 percent in the normal population. The case of a 25-year-old man whose immune system did not function is reported. He had blisters on the tip of his tongue which formed ulcers within 24 hours; he was treated with medication for pain and applications of acyclovir ointment (inhibits herpes virus). Meanwhile he continued his treatment with clotrimazole for oral candida infection and povidone-iodine solution for acute necrotizing ulcerative gingivitis. After three days of analgesics and acyclovir treatment he was able to eat again; the herpes tongue lesion was smaller and no longer painful. Treatment of HSV was important to the general medical condition of this patient because the tongue blister and ulcers had led to significant weight loss. After resolution of the tongue lesion he was able to regain some weight. Although the patient died a month after treatment for HSV, he was more comfortable for that period of time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Evaluation, Drug therapy, AIDS patients, Acyclovir, Mouth diseases, Herpes simplex

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Doctor-patient confidentiality and the potentially HIV-positive patient

Article Abstract:

The dilemma of a dentist dealing with the decision of how to handle a confidentiality issue is presented. By hearsay the dentist is aware of the patient's possible homosexuality and potential risk for HIV infection. He is referring the patient to an oral surgeon for further care. Is he breaching patient-doctor confidentiality if he tells the surgeon of the patient's possible homosexuality? Should he share this information to protect his colleague and his staff? He finally decided to protect the patient's right of privacy. The editor raised the issue that since the information did not come directly from the patient to the dentist (the dentist was informed by another patient), this may not be considered protected information. The Council on Ethics notes that standards for disclosure vary from state to state; disclosure is usually allowed only to protect the health of the infected individual. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ethical aspects, Dentistry, Confidential communications, Dentist and patient, Dentist-patient relations, Dental ethics

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HIV-associated periodontal disease: new oral spirochete found

Article Abstract:

An investigation supports the hypothesis that tentatively-called pathogen-related oral spirochete (PROS) is found in the plaque of HIV-associated periodontal disease patients. Periodontal disease was defined by tooth mobility, pocket depth of 4 millimeters or greater and/or an erythematous band at the gingival collar that was associated with pain. PROS was rarely found in plaque of adults with healthy periodontal tissues. Ten of 11 patients with HIV-associated periodontal disease had PROS. The eleventh patient had no detectable spirochetes. As the CD4/CD8 ratio falls, HIV gingivitis and periodontitis increase. The presence of PROS in HIV-associated periodontal disease may be another hazard for people with AIDS.

Complications and side effects, Physiological aspects, HIV infection, HIV infections, Spirochete infections, Periodontal disease, Periodontal diseases

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