Manifestations of HIV in the oral cavity: symptoms with a photo, what the tongue looks like, sores in the throat, teeth with AIDS

HIV infection is a disease caused by the human immunodeficiency virus. Without specialized treatment, it passes into the terminal stage - AIDS (acquired immunodeficiency syndrome) and ends in death.

The virus infects the cells of the immune system lymphocytes and entails the vulnerability of the body to various infections that are harmless for a healthy person.

Identification of the immunodeficiency virus is an important task of modern medicine

HIV is a common disease. The number of infected people in Russia is growing every year. Every day 80 people with HIV die in Russia (HIV in numbers

). More than half of all cases of infection were recorded in 13 constituent entities of the Russian Federation, Rosstat, p.228.

In most cases, the disease is transmitted sexually, through non-sterile medical instruments (for example, with intravenous injection of drugs with a shared syringe), it is impossible to vaccinate or develop immunity from it. These facts determine the actual defenselessness of each person against the immunodeficiency virus.

Timely started antiviral therapy and constant monitoring make it possible to extend a person's life up to 70-80 years. The earlier treatment is started, the more favorable the prognosis will be. The manifestations of HIV infection in the oral cavity appear in the early stages. At the same time, the oral cavity is well accessible for examination (in contrast to the lungs, stomach), which makes it possible to detect suspicious symptoms in time. Therefore, it is extremely important for every person to have at least a minimal understanding of the symptoms of HIV infection in the oral cavity.

Provoking factors - why infection occurs

The immunodeficiency virus enters the body through microtrauma of the mucous membrane during unprotected intercourse, or into the bloodstream during the violation of the integrity of the skin with a non-sterile syringe. The blood stream delivers virions to the lymph nodes, where they are incorporated into the RNA of immune cells - lymphocytes. The multiplication of the virus inside the cell blocks its ability to protect the body from foreign agents, which leads to multiple diseases of the organs and systems of the infected person.

The virus gradually reduces the ability of the mucous membranes in the mouth to resist fungi and bacteria. The possibility of destruction of atypical malignant cells by lymphocytes of the dentoalveolar region is also blocked. HIV-associated lesions in the mouth arise as a result of a failure of the general immune system.

Complex clinical picture

The presence of an infection in the mouth of any localization (stomatitis, cheilitis, glossitis, gingivitis), difficult to treat, is an alarming sign and may be a manifestation of HIV. This is a signal that the immune system cannot cope with the infection and the person may be a carrier of immunodeficiency viruses.

It is worth suspecting something wrong if the listed diseases are protracted and cannot be treated with antibacterial and antifungal drugs.

Overall view of the oral cavity

HIV and AIDS are characterized by different inflammatory reactions in the oral cavity - erosion, ulcers, blisters, often occurring in the mouth and poorly treated with standard drugs. Often available heavy breathdue to the addition of a secondary bacterial infection.

The appearance of the tongue in HIV

Tongue covered white bloom, densely populated by a colony of fungi of the genus Candida. It does not peel off on its own; after removal with tools, a reddened and bleeding mucous membrane is determined under it.

Lateral surfaces are affected leukoplakia. It forms growths of the epithelial layer, which have the appearance of whitish or light yellow thin villi.

In the photo, the main symptoms in the tongue with HIV are candidiasis, leukoplakia:

Throat view

The mucous membrane on the throat with HIV is hyperemic, covered with erosions and white ulcers, 3-5 mm in diameter. Sometimes abscesses appear on it, which look like yellow vesicles with contents of a thick consistency.

Cheeks

On the mucous membrane of the cheeks in the area of ​​closing the teeth, areas of compaction of the epithelial layer in the form of a white film are formed. There are hemorrhages in the submucous tissues - multiple red dots, 1-2 mm in diameter.

Gum type

Gingival papillae deformed due to ulcerative necrotizing gingivitis. The mucous membrane is covered with a white dense coating, which gives off an unpleasant odor.

However, the immunodeficiency virus infects the entire body, not local organs. Therefore, in order to suspect a diagnosis of HIV, it is necessary to pay attention to the following accompanying symptoms:

• sudden unexplained weight loss;
• fever lasting longer than 1-1.5 months for no apparent reason;
• simultaneous enlargement of lymph nodes in different parts of the body (cervical, axillary, inguinal).

Therefore, all manifestations of HIV in the oral cavity are accompanied by symptoms of general damage to the body.

Classification of common lesions

All diseases that form in the oral cavity with HIV can be divided into 2 large groups.

Lesions that almost always occur with the development of an infection:

• Kaposi's sarcoma - a malignant tumor, has the appearance of purple or dark blue protruding spots on the mucous membrane, with a diameter of 1 to 4 cm, the surface is uneven, bumpy;
• Non-Hodgkin's lymphoma - malignant tumor of the dentoalveolar region, accompanied by an increase in lymph nodes, destruction of bone tissue around the teeth, swelling and redness of the mucous membrane in the affected area;
• hairy leukoplakia - formed on the tongue (on the lateral surface), looks like white villi;
• candidiasis - fungal infection, manifested by hyperemia of the mucous membrane and abundant white or yellow bloom, which cannot be removed on its own;
• ulcerative necrotizing gingivitis associated with HIV - has a bacterial nature, arises suddenly, with acute manifestations, after a while the gum tissue dies off, forming a defect, relapses often occur.

More rare manifestations:

• thrombocytopenic purpura - a disease of the hematopoietic system, manifested by hemorrhages in the mouth, which have the appearance of a punctate red rashes;
• bacterial and viral infections - affect the gums, periodontium, lips, language, are resistant to antibiotics and antiviral drugs, frequent relapses;
• diseases of the salivary glands.

Stages of infection

HIV proceeds in several stages, which manifest themselves in different ways:

1. Incubation period - starts from the moment the virus enters the bloodstream, lasts up to 6 months. There are no manifestations in the oral cavity.
2. The period of acute manifestation of infection - manifested by symptoms of a respiratory disease - fever, runny nose, sore throat. From the side of the oral cavity - an increase in the submandibular, sublingual, parotid, periopharyngeal lymph nodes.
3. Latent stage - lasts from 5 to 7 years. The oral cavity is affected by viral and bacterial infections, mycoses. The incidence of diseases can be 3-4 times a year.
4. Stage of AIDS - specific lesions appear in the mouth: Kaposi's sarcoma, non-Hodgik's lymphoma, hairy leukoplakia, persistent mycoses and candidiasis.

Diagnostics, examination and differential diagnosis

The only reliable way to diagnose HIV is with a blood test. The most widely used method is the enzyme-linked immunosorbent assay (ELISA), which shows the presence of HIV antibodies in the blood. If less than 6 months have passed since the moment of infection, antibodies to the virus will not have time to develop, and the analysis will show an erroneous negative result.

If a positive result is obtained after ELISA, the second stage of the examination is assigned - immune blotting. The principle of its operation is the presence of an electric field, which detects the antibody molecules with a guarantee of an accurate result.

The manifestations of HIV in the oral cavity must be differentiated from other bacterial and viral diseases (herpes, tuberculosis, syphilis), from some autoimmune diseases (lichen planus). For the final diagnosis, laboratory tests are critical.

Treatment methods

Therapy of HIV infection and its manifestations in the oral cavity should be comprehensive and carried out with the participation of an infectious disease specialist, dentist, and otorhinolaryngologist. If necessary, doctors of other specialties (surgeons, oncologists) should be involved in the treatment. It is mandatory to observe the patient every 4 months for the timely detection of possible complications.

General

Antiviral therapy is prescribed for treatment. Preparations and dosage are selected individually for each patient by the attending infectious disease doctor.

Modern therapy allows a person to live to a ripe old age, subject to adherence to the prescribed medicines and periodic blood tests to determine the effectiveness of treatment and viral concentration in the body.

It is important to maintain a healthy lifestyle - quitting smoking, alcohol, drugs, adherence to daily regimen, nutritional balance, stress management, moderate physical activity, exercise physical education.

Dental care

Dental care for HIV-infected people is provided on an equal basis with other patients in all dental institutions of the Russian Federation. Treatment is divided into 3 groups:

1. Etiological - carried out for bacterial and viral infections. Antibiotics and antiviral drugs are selected and assigned based on the sensitivity of the pathogen to them.
2. Preventive - prevention of recurrence of the disease. Includes filling carious teeth, removal of dental plaque, general reorganization.
3. Symptomatic - treatment of ulcers and erosions with anesthetics (Lidocaine spray and gel), antiseptics (Chlorhexidine, Furacilin), the appointment of healing drugs (Solcoseryl, sea buckthorn oil).

Preventive measures

Prevention of HIV infection is the use of personal protective equipment during intercourse, the use of sterile instruments when performing manipulations associated with a violation of the integrity of the skin and mucous membranes (injections, blood sampling and transfusion, treatment dentist).

Prevention of possible manifestations of HIV in the oral cavity is a timely visit to the dentist, treatment or extraction of teeth as needed, hygienic cleaning at the dentist.

Effects

HIV requires lifelong treatment and supervision by an infectious disease doctor. Refusal to take antiviral drugs leads to damage to almost all organs and systems with secondary bacterial diseases and malignant neoplasms due to the failure of immune cells.

In the early stages, the consequences of HIV are:

1. Fever, accompanied by a rise in body temperature, chills, sweating (especially at night). This condition can accompany the patient several times a month, for no explainable reason.
2. Frequent stool disorder (diarrhea), sudden weight loss.
3. Upper respiratory tract infections (tonsillitis, laryngitis), ENT organs (sinusitis, otitis media, sinusitis). They are fungal and bacterial in nature and do not disappear after treatment with standard drugs.

A late complication of the infection is the AIDS stage. Her signs:

1. Pneumocystis pneumonia.
2. Pulmonary candidiasis.
3. Multiple fungal skin lesions.
4. Fungal and bacterial lesions of the brain - manifested by headache, impaired consciousness, convulsions.

Without treatment with antiviral drugs, the mortality rate at the AIDS stage is 100%.