AIDS/HIV Disease

Have you been diagnosed with AIDS?#

An acquired immune deficiency syndrome (AIDS) diagnosis is based on a positive human immunodeficiency virus (HIV) test and one of several opportunistic infections, or a CD4 cell count <200 cells/µL. Once an AIDS diagnosis has been made, the patient will always be categorized as having AIDS, even when no opportunistic infection is present or the CD4 cell count has rebounded to >200 cells/µL. However, a patient’s current level of immune suppression is more relevant to oral health care delivery.

Have you experienced any opportunistic infections?#

HIV infection causes impairment of the immune system, which increases susceptibility to opportunistic infections including an array of different head and neck manifestations, such as salivary gland disease , lymphadenopathy , and oral manifestations, including candidiasis , herpes simplex virus infections , cytomegalovirus infections , oral hairy leukoplakia , human papilloma virus infections , Kaposi’s sarcoma , periodontal diseases , necrotizing stomatitis , Non-Hodgkin’s lymphoma , and major aphthous ulcerations . Certain opportunistic infections are AIDS-defining illnesses.

What are your most recent laboratory values?#

Laboratory values reflect the medical status of the HIV-infected patient.

CD4 cell count is a measure of immune competence.

Changes in HIV viral load is a measure of HIV disease progression and efficacy of anti-HIV medications.

A complete blood cell count (CBC) with differential will indicate if the patient has a low neutrophil count, which would indicate an increased susceptibility to bacterial infections; has a predisposition to certain bleeding tendencies; or suffers from some type of anemia.

Have you ever used intravenous drugs?#

Patients with a history of intravenous drug use are at an increased risk of contracting hepatitis B virus (HBV) and/or hepatitis C virus (HCV), developing infective endocarditis, and exhibiting drug-seeking behavior.

Have you ever been diagnosed with hepatitis?#

Many HIV-infected individuals are coinfected with HBV and/or HCV. These infections may result in progressive liver destruction and consequent liver impairment.

Have you ever been diagnosed with tuberculosis (TB)?#

Special infection-control measures are necessary for patients with active pulmonary or laryngeal TB. Patients with inactive TB can be treated safely in a dental setting without added precautions.

What types of medications are you taking?#

Highly active antiretroviral therapy (HAART) is the mainstay of HIV therapy. Patients will take two or more antiretroviral medications, separately or in combination. Several antiretroviral medications have oral adverse sequelae, the most common oral side effect being salivary gland dysfunction and xerostomia that may place the patient at increased risk for dental caries and mucosal candidiasis .

Medications to treat and prevent opportunistic infections are given if the patient has an active infection or a low enough CD4 Cell Count that he or she is highly susceptible to a specific opportunistic infection.

Medications are also given to boost specific cell populations, such as red blood cells or neutrophils.

Related Pages#

Oral Health Care Considerations
- AIDS and HIV Disease
Medications
- Anti-Retro Viral Medications
Laboratory Values
- CD4 Cell Count
- HIV Viral Load
Classifications and Definitions
- AIDS Defining Conditions
- HIV Disease