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How is HIV spread

Sex
Infected blood/blood products
Mother to baby

Which cells are mainly affected in HIV

CD 4 T-helper cells

Which immunity does T-helper cells participate in

Cell mediated immunity & regulating immune response

How do you diagnose AIDS

HIV with CD4 depletion
CD4 less than 200

What is a normal CD 4 level

550-1000

Testing for HIV first test

ELISA-Test for circulating antibiodies

2nd test for HIV

2 positive ELISA do
Western blot test
Circulating antibodies

What does the AIDS virus infect

Cells of the immune system

Symptoms of AIDS related complex

Candidiasis
Fatigue
Weight loss
Lymphadenopathy

When does the antibodies to HIV become detectable

6 weeks after infection

Definiton of window of infectivity

Antibodies may not be detectable for 6 months-1 yr or longer

What test measures the amount of HIV circulating in serum

PCR
Only test that doesn't measure circulating antibody

2 ways to assess HIV infection

Measure viral load
CD4 cell count

Pt management of HIV include

Antiretroviral meds
Drugs to treat opportunistic infections

Oral lesions occur due to what

Deficiency in CMI (cell mediated immunity) & depletion of T helper cells

Oral manifestations of AIDS

Candidiasis
Herpes
Hairy Leukoplakia
Kaposi Sarcoma
Bilateral salivary gland enlargement

Treatment of Candidiasis in HIV pt

Topical/Systemic antifungal meds
Recurrence is common

What does candidiasis signal

Beginning of progresively severe immunodeficiency

Herpes not resolved in 1 month means

Diagnosis of AIDS

Herpes Zoster signals

Developing immunodeficiency

What is hairy leukoplakia

Epstein barr virus

Where does hairy leukoplakia occur

Lateral borders of tongue

What can hairy leukoplakia also resemble

Chronic tongue chewing & hyperplastic candidiasis

What is the most reliable method of diagnosis of hairy leukoplakia

Epstein barr virus being present

Hairy leukoplakia is a predictor of what

Progression of HIV to AIDS

What must you rule out with hairy leukoplakia

HIV infection

HPV in HIV pt may be associated with what

Antiretroviral tx

What is Kaposi sarcoma

Opportunistic neoplasm

Where is Kaposi sarcoma usually located

Palate/Gingiva

How do you diagnose Kaposi sarcoma

Biopsy

Tx of Kaposi sarcoma

Surgical removal
Radiation tx
Chemo

What is lymphoma

Malignant tumor

How do we treat lymphoma

Chemo

What perio dz may a HIV pt have

Linear gingival erythema (red band around teeth)
NUP-Necrotizing ulcerative perio

Characteristics of linear gingival erythema

Bleeding
Punctate/petechiae on attached gingiva or alveolar mucosa
Band like redness on gingiva that is non responsive to tx

T/F linear gingival erythema occurs independant of OH status

True

Charcteristics of NUP

Intense redness
Extreme rapid bone loss

What is necrotizing stomatitis

Extensive focal areas of bone loss along with NUP

Tx of perio dz in HIV pt

SRP
Soft tissue curettage
Intrasulcular lavage
Chlorhexidine
Flagyl (systemic metronidazole)

What causes spontaneous gingival bleeding in HIV pt

Decrease in platelets

What causes a decrease in platelets in HIV pt

Autoimmune type of thrombocytopenic purpura

What needs to be considered before deep scaling of HIV pt with lower platelets

Platelet count and bleeding time

Charcteristics of aphthous ulcers in HIV pt

Increase in # of ulcers
Resemble major apththous ulcers
Lesions respond to steroids

What may salivary gland enlargement in HIV pt be related to

Meds or salivary gland disease

What is mucosal melanin pigmentation

Macular areas of melanin pigmentation
Cause unclear

Definitive Diagnosis of AIDS

Candidiasis
Hairy Leukoplakia
Kaposi sarcoma
Herpes simplex lesion lasting > 1 month
Herpes zoster
HPV
Aphthous ulcers
Salivary gland enlargement
Mucosal pigmentation
Oral lymphoma
< 200 CD4 T cell count
Esophageal candidiasis
Invasice cervical cancer

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