Risk factors for rapid progression from hairy leukoplakia to AIDS: a nested case-control study

Article Abstract:

Hairy leukoplakia (a viral infection causing hairy white patches on the tongue and mucous membranes of the mouth) is often seen in those infected with HIV, the human immunodeficiency virus. Hairy leukoplakia often occurs early in the course of HIV infection, and may be the first sign of the infection. Studies estimate that individuals who test positive for HIV antibodies will progress to full-blown AIDS within 18 to 36 months of showing signs of hairy leukoplakia. The time lag varies widely, however, and studies performed so far have had relatively small numbers of subjects. To determine what clinical factors might speed the progression from HIV infection to AIDS in individuals who have hairy leukoplakia, those who progressed to AIDS rapidly were compared with those who did not progress within 1,000 days. There were 28 patients in the group that progressed rapidly and 27 in the group that did not. Subjects underwent medical examination and provided information from which a history was constructed. Risk factors emerged upon statistical analysis and fell into two broad categories: sexual practices which correlated with how early during the AIDS epidemic patients were likely to have been infected, and factors reflecting the strength of the immune system. Regarding the latter, patients with a history of hepatitis B or syphilis had a four- and three-fold increase, respectively, in the likelihood that they would progress rapidly from HIV infection to AIDS. Of the skin tests performed, inability to show an immune response to Candida (yeast) was found in all 17 patients tested in the early progression group and in only two of 12 tested in the other group. Therefore, infection early in the AIDS epidemic, history of certain sexually transmitted diseases, and poor immune response to a skin test for Candida seem to be predictive of a relatively quick progression from HIV infection to AIDS in individuals with hairy leukoplakia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Development and progression, AIDS (Disease)

---

Efficacy of desciclovir in the treatment of Epstein-Barr virus infection in oral hairy leukoplakia

Article Abstract:

Oral hairy leukoplakia, characterized by raised, white, rough lesions on the tongue or inner cheek, has been associated with the subsequent development of AIDS (acquired immune deficiency syndrome). Epstein-Barr virus (EBV) is present in the lesion; when it is not, the lesion is termed 'pseudo-hairy leukoplakia'. EBV has been shown to be sensitive to acyclovir, however acyclovir is poorly absorbed in the mouth. An analog of acyclovir, desciclovir, is readily absorbed orally. In this study, desciclovir was given in low doses in order to determine its usefulness in eliminating hairy leukoplakia lesions and suppressing EBV infection. The 14 patients were immunocompromized male homosexuals with the diagnosis of hairy leukoplakia; some had symptoms of HIV (human immunodeficiency virus) infection while others were clinically healthy, but none had AIDS. They were randomly assigned to a treatment or placebo (non-treated) group. Treatment consisted of receiving 250 milligrams of desciclovir three times a day for 14 days. In all eight patients receiving treatment, the lesions either resolved completely or showed significant improvement. No change was seen in the placebo group. Histologic (tissue) evaluation revealed the characteristics of HL to be diminished; other studies revealed EBV to be either eliminated or drastically reduced in the treatment group only. Four patients on desciclovir reported side effects of headaches, neck and jaw aches, or rapid heart beat, but the side effects were not severe enough to require discontinuation of treatment. At the end of the study, following discontinuation of desciclovir in the treatment group, all eight patients had recurrence of HL within one to four months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Epstein-Barr virus

---

Management of the oral lesions of HIV infection

Article Abstract:

A review is presented of the oral signs of infection with human immunodeficiency virus (HIV), associated with AIDS. At least 40 such manifestations of HIV infection are now known. While oral lesions (sores) cause significant discomfort, many can be treated using relatively simple approaches. Five main disease classifications are discussed: fungal (candidiasis, histoplasmosis, cryptococcosis); viral (herpes simplex, hairy leukoplakia, herpes zoster, warts); bacterial (HIV-gingivitis, HIV-periodontitis, necrotizing gingivitis and stomatitis, mycobacterium avium intracellulare); neoplastic, or malignant (Kaposi's sarcoma and lymphoma); and other conditions (aphthous ulcers, HIV-salivary gland disease, immune thrombocytopenic purpura). The clinical appearance and recommended therapy for each is presented, along with possible side effects if therapeutic drugs are combined with drugs taken for HIV infection (AZT, ddI, ddC). Besides their obvious importance in determining the course of treatment, oral examinations of HIV-infected patients help diagnose the presence, as well as the stage, of infection. The provision of routine dental care (filings, endodontic work) is not difficult in these patients, and they should be referred to specialists using the same criteria that are applied to non-infected patients. Programs that specialize in oral care for AIDS patients are not able to handle the growing number of HIV-infected patients; hence, general practitioners and oral surgeons should anticipate treating these people on a routine basis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Dentists, Oral manifestations of general diseases, Oral manifestations

Similar abstracts:

• Abstracts: Risk factors for Kaposi's sarcoma in the Vancouver lymphadenopathy-AIDS study. Use of the Markov model to estimate the waiting times in a modified WHO staging system for HIV infection
• Abstracts: N-3 fatty acid effects on lipids, lipoproteins, and apolipoproteins at very low doses: results of a randomized controlled trial in hypertriglyceridemic subjects
• Abstracts: Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. part 2
• Abstracts: Dealing with chiropractors: gaining a sense of reality when presenting credentials. The chickens are coming home to roost

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.