The human immunodeficiency virus The human immunodeficiency virus (HIV) is a retrovirus responsible for the acquired immune deficiency syndrome (AIDS). The first human retrovirus, human T-cell lymphotrophic virus type I, was isolated in1980 from a patient with T-cell leukaemia. The clinical manifestations of HIV infection were first recognized in 1981

Gabar aan Hooyo laheyney 12 magacleey The country of origin of the virus is unknown, although there is fairly strong presumptive evidence that the initial centre of activity was in central Africa

HIV infection is, however, a rapidly expanding worldwide problem, although, quite clearly, prognostication in these circumstances is a very difficult process and there can be no degree of certainty about the many projections of future patient numbers that have been made.

Transmission of the virus Transmission of the virus is currently thought to be predominantly via blood and blood products and semen. Perinatal and postnatal transmission occur in about 20 per cent of infants born to infected mothers

Oral manifestations of HIV infection The oral manifestations of HIV infection are considered to be of great significance and have been classified as two groups: group 1, lesions commonly associated with HIV infection; and group 2, lesions less commonly associated with HIV

The most significant infection The most significant consideration concerns the changes that may appear in the oral cavity of a patient with HIV infection that has not, as yet, been diagnosed

oral changes The likely oral changes are dependent on the increasing reduction in immune surveillance, presenting either as infections or as neoplasms. The most likely infection is candidosis

Oral manifestations of HIV infection

Diseases strongly associated with HIV Candidosis Erythematous Pseudomembranous Hairy leukoplakia Periodontal disease Linear gingival erythema Necrotizing ulcerative gingivitis Necrotizing ulcerative periodontitis Kaposi's sarcoma Lymphoma

Lesions less commonly associated with HIV infection

Mycobacterial infections Melanotic pigmentation Necrotizing (ulcerative) stomatitis Cystic salivary gland disease Thrombocytopenic purpura Non-specific ulceration Viral infections including Herpes simplex, Herpes zoster, and human papilloma virus infection

KAPOSI'S SARCOMA The neoplasm that is most likely to occur in the AIDS patient is Kaposi's sarcoma The mouth and, in particular, the mucosa of the hard palate is a common site for this lesion, which is, in fact, a form of diffuse lymphoma

The lesion is described as a pigmented The lesion is described as a pigmented, nonpainful, slightly nodular lesion of the mucosa with a characteristic histological appearance. Before the recognition of AIDS this was considered to be a rare lesion, confined to elderly patients of several restricted racial groups (Bantu, Jewish, and Italian) or to patients on immunosuppressive therapy

Homosexual men Homosexual men are considered to be more at risk from Kaposi's sarcoma than other groups with HIV infection. The herpes virus 8 (HHV-8) is now considered to have a role in the aetiology of this sarcoma.

Kaposi’ sarcoma