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5th Oral Disease - Oral Infection > HIV Infection > Flashcards

HIV Infection Flashcards

1
Q

What is HIV?

A

Human immunodeficiency virus

Type of retrovirus

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2
Q

Give more information of the retrovirus HIV

A

Single stranded RNA w/ reverse transcriptase gene

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3
Q

How is HIV spread?

A

Bodily fluid - unprotected sex/ IV drug use

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4
Q

What does HIV do?

A

Damage immune and nervous system = severe immunodeficiency

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5
Q

Where is cell receptor for HIV found?

A

CD4 molecule

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6
Q

When does AIDS occur?

A

When CD4 cell count <200/uL

normal >600/uL

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7
Q

Steps of HIV infection?

A
  1. Exposure to virus
  2. Acute seroconversion illness
  3. Asymptomatic - HIV+
  4. Persistant generalised lymphadenopathy
  5. AIDS-related complex - pyrexia, weight loss, fatige
  6. AIDS- opportunistic infections e.g kaposi’s sarcoma
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8
Q

How diagnose HIV/AIDS?

A

Hx and clinical features
General lab investigation - CD4 count, CD4/CD8 ratio
HIV testing

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9
Q

What are the different groups of HIV oral manifestations?

A

Group 1 - strongly associated HIV
Group 2 - less commonly associated
Group 3 - possible association

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10
Q

Examples of group 1 oral manifestations?

A 
Candidosis
Hairy leukoplakia 
HIV associated periodontal disease
Kaposi's sarcoma
Non-hodgkin's lymphoma
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11
Q

What types of candida can be seen in HIV pts?

A

Erythematous or pseudomembranous

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12
Q

What is tx of candida infections?

A

Antifungals

Topical - miconazole/ nystatin
Systematic - fluconazole/ itraconazole/ voriconazole

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13
Q

How would expect hairy leukoplakia to present?

A

Bilaterally

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14
Q

What is important to remember about hairy leukoplakia?

A

Not premalgiannt

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15
Q

What can cause hairy leukoplakia?

A

EBV

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16
Q

Tx of hairy leukoplakia?

A

Generally not required

Can regrew w/ acyclovir - return of stopping

17
Q

What types of perio are associated w/ HIV?

A

Linear gingival erythema
NUG
NUP
NUS - necrotising ulcerative stomatitis

18
Q

What is the aetiology of HIV associated periodontitis?

A

Spirocheates
Fusiform bacteria
Anaerobic rods

In linear gingival erythema - candida may play role

19
Q

What is immediate management of HIV associated perio?

A

Removal necrotic bone and severely involved teeth
Debride necrotic tissue
6% hydrogen peroxide irrigation of pocket
Abs - metronidazole
OHI

20
Q

What is long-term management of HIV associated perio?

A

Periodontal management

21
Q

What causes Kaposi’s sarcoma?

A

HHV8

22
Q

What is the management of kaposi’s sarcoma?

A

Radio/chemotherapy

23
Q

What are group 2 lesions associated w/ HIV?

A

Aytipical oropharyngeal ulceration
Idiopathic thrombocytopenic purpa
Salivary gland disorder
Viral infections

24
Q

What causes idiopathic thrombocytopenic purpa?

A

Low platelet count resulting in purpuric patches on oral mucosa

25
Q

Problem w/ low platelet count and dentistry?

A

If XLA risk post-XLA bleed

26
Q

What does salivary gland disorder cause?

A

Dry mouth due reduced salivary flow rate

Due to swelling major salivary glands

27
Q

Tx of salivary gland disorder?

A

Tx saliva stimulant and oral lubrication

28
Q

What viral infections are associated w/ HIV?

A

Cytomegalovirus
Herpes simplex
HPB
Herpes zoster

29
Q

What might you see orally w/ cytomegalovirus?

A

Severe or atypical oral ulcers

30
Q

Examples of group 3 lesions?

A

Oral bacterial infection (not perio)
Fungal infection (not candidiasis)
Malanotic hyperpigementation
Neurological disturbance

31
Q

What are examples of neurological disturbance caused HIV?

A

Facial palsy

Trigeminal neuralgia

32
Q

What is the systemic tx provided those w/ HIV?

A

Modern combination anti-retroviral tx - HAART

Prophylactic tx for opportunistic infection

Very effective at preventing progression to AIDS

33
Q

What does the tx of HIV aim to do?

A

Reduce immunosuppression and associated opportunistic infections and tumours

34
Q

What to do if get needle stick/ occupational exposure?

A 
Encourage bleeding under running water
Apply or scrub w/ antiseptic 
Cover wound
Irrigate exposed eyes, nasal or oral mucosa
Record in accident book

Report exposure occupational health

35
Q

If occupational exposure occurs what do you need pt permission for?

A

Bloods - clinical and serological evaluation of HIV/ HBV status

36
Q

What will occupational health arrange?

A

Post-exposure prophylaxis w/ AZT

HBV/ HIV testing

37
Q

What causes immunosuppression associated w/ HIV?

A

Depletion of CD4 T helper cells

5th Oral Disease - Oral Infection (3 decks)

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