Page 5 - GP Spring 2024

This is particularly important because of uals living with HIV. Two of these articles 5. Ramírez-Amador V, Esquivel-Pedraza L, Si-
the study by Radithia et al., which indicat- examined various oral manifestations in the erra-Madero J, Anaya-Saavedra G, González-
ed the prevalence of oral hyperpigmentation context of HAART, shedding light on the Ramírez I, Ponce-de-León S. The Changing Clin-
ical Spectrum of Human Immunodeficiency Virus
in a quarter of patients undergoing HAART complex relationship between HIV infec- (HIV)-Related Oral Lesions in 1,000 Consecutive
therapy. Overall, this study was a high-qual- tion, HAART treatment, and oral health. The Patients: A 12-Year Study in a Referral Center in
ity systematic review that was determined to studies found that there was a selective de- Mexico. Medicine (Baltimore). 2003;82(1):39-
have a low level of bias using the Newcas- crease in the prevalence or risk of particular 50. doi:10.1097/00005792-200301000-00004
tle-Ottawa Scale. However, there was a high oral manifestations; however, many of these 6. Mosca NG, Rose Hathorn A. HIV-positive
patients: dental management considerations.
level of heterogeneity in the prevalence due improvements regressed in the long term and Dent Clin North Am. 2006;50(4):635-viii.
to differences in study populations, method- demonstrated an increased prevalence. Addi- doi:10.1016/j.cden.2006.06.006.
ology, and geographical locations. Addition- tionally, the final study, which delved into the 7. Nittayananta, W., Talungchit, S., Jaruratana-
ally, of the 11 studies in this review, most unique oral manifestation of hyperpigmenta- sirikul, S., Silpapojakul, K., Chayakul, P., Nil-
were cross-sectional, and only one was a co- tion as an adverse effect of HAART therapy, manat, A., & Pruphetkaew, N. (2010). Effects of
long-term use of HAART on oral health status of
hort study. This limited the ability to establish highlights the need for healthcare providers HIV-infected subjects. Journal of oral pathology &
causal relationships or longitudinal trends in to be aware of and address this issue. medicine : official publication of the International
the prevalence of oral hyperpigmentation. Association of Oral Pathologists and the Ameri-
Collectively, these articles enrich our un- can Academy of Oral Pathology, 39(5), 397–406.
The studies by Nittayananta et al. and V.L. de derstanding of the complex relationship https://doi.org/10.1111/j.1600-0714.2009.00875.x
8. de Almeida, V. L., Lima, I. F. P., Ziegelmann,
Almeida et al. looked at several of the same between HAART therapy and oral health P. K., Paranhos, L. R., & de Matos, F. R. (2017).
manifestations, such as erythematous candi- in HIV-infected individuals. While HAART Impact of highly active antiretroviral therapy on
diasis, pseudomembranous candidiasis, and offers benefits in reducing oral manifesta- the prevalence of oral lesions in HIV-positive
aphthous ulcers. Nittayananta et al. found tions, the duration of therapy and potential patients: a systematic review and meta-analy-
that both erythematous and pseudomembra- side effects like hyperpigmentation warrant sis. International journal of oral and maxillo-
facial surgery, 46(11), 1497–1504. https://doi.
nous candidiasis had a decreased prevalence continued attention and research. Monitor- org/10.1016/j.ijom.2017.06.008.
with long-term HAART therapy; however, ing and addressing oral health are pivotal in 9. Radithia, D., Subarnbhesaj, A., Ayuningtyas,
short-term therapy was only beneficial for enhancing the overall quality of life for in- N. F., Bakti, R. K., Mahdani, F. Y., Pratiwi, A. S.,
erythematous candidiasis. At the same time, dividuals undergoing HAART therapy. Fur- Ayunnisa, N., Putri, S. F., & Pramitha, S. R. (2023).
aphthous ulceration had very little benefit ther studies are needed to refine treatment Oral hyperpigmentation as an adverse effect of
highly active antiretroviral therapy in HIV patients:
with either short-term or long-term HAART strategies and optimize outcomes for this A systematic review and pooled prevalence. Jour-
therapy. V.L. de Almeida et al. found a de- patient population. nal of clinical and experimental dentistry, 15(7),
creased prevalence of both erythematous e561–e570. https://doi.org/10.4317/jced.60195.
candidiasis and pseudomembranous candi- Monitoring and addressing oral health are
diasis in association with HAART therapy; pivotal in enhancing the overall quality of Athman Sivaseelan is a
however, the prevalence was only calculat- life for individuals undergoing HAART dental student at NYU
ed over a single range in time, as opposed therapy. Regular dental check-ups and oral Dentistry, class of 2025.
to examining manifestations over both the hygiene practices play a crucial role in pre-
short-term and long-term. venting and managing oral manifestations
associated with this treatment. Moreover,
Nittayananta, W. et al. is a moderate-qual- dental professionals should be knowl-
ity cross-sectional study with a moderate edgeable about the potential side effects
risk of bias. While the inclusion and exclu- of HAART therapy to proactively address Aanchal Parmar is a
sion criteria, measurement methods, and them. By implementing comprehensive oral dental student at NYU
data collection procedures of this study are care protocols, healthcare providers can Dentistry, class of 2024.
well-described, the results are not general- optimize the efficacy of HAART therapy
izable to the general population as the study and improve the oral health outcomes of
was conducted in Southern Thailand over a HIV-infected individuals.
decade ago. Further studies examining sim-
ilar manifestations in other locations and References Angela De Bartolo, DDS
an international study may be beneficial to 1. Eggleton JS, Nagalli S. Highly Active Antiret- is a Clinical Associate
roviral Therapy (HAART). In: StatPearls. Treasure
generalize findings. Island (FL): StatPearls Publishing; July 3, 2023. Professor at NYU Col-
2. Thompson, M. A., Aberg, J. A., Hoy, J. F., Telenti, lege of Dentistry in the
V.L. de Almeida et al. is a high-quality sys- A., Benson, C., Cahn, P., Eron, J. J., Günthard, H. F., Department of Cariolo-
tematic review with a low risk of bias and Hammer, S. M., Reiss, P., Richman, D. D., Rizzardi- gy and Comprehensive
heterogeneity as determined using the Co- ni, G., Thomas, D. L., Jacobsen, D. M., & Volber- Care, and she is a Group
ding, P. A. (2012). Antiretroviral treatment of adult
chran Q test, which found an overall low HIV infection: 2012 recommendations of the Interna- Practice Director and Senior Mentor for
heterogenicity for many of the lesions stud- tional Antiviral Society-USA panel. JAMA, 308(4), the NYU Dentistry Gies Society.
ied. This analysis is based on 7 studies of an 387–402. https://doi.org/10.1001/jama.2012.7961.
initial 522 studies identified for inclusion. 3. Patton LL, McKaig RG, Rogers D, Strauss RP, Dr. Analia Veitz-Keenan
The largest limitation of this study is the Eron JJ. The role oral manifestations of HIV and is a Clinical Professor at
body signs in suspicion of possible HIV infection.
lack of comparison between long-term and Oral Surg Oral MedOral Pathol Oral Radiol En- NYU Dentistry Depart-
short-term therapy population groups. dod. 1998;85:146. ment Oral Maxillofacial
4. Ravina A, Ficarra G, Chiodo M, Mazzetti Pathology, Radiology and
Conclusion: M, Romagnani S. Relationship of circulat- Medicine and Epidemiolo-
In conclusion, the articles explored the vital ing CD4+ T-lymphocytes and p24 antigene- gy and Health Promotion.
mia to the risk of developing AIDS in HIV-in-
relationship between managing medically fected subjects with oral hairy leukoplakia. She has a private practice in Brooklyn, NY,
compromised patients undergoing HAART J Oral Pathol Med. 1996;25(3):108-111. and is NYSAGD’s 2024-25 president.
therapy and oral manifestations in individ- doi:10.1111/j.1600-0714.1996.tb00203.x
www.nysagd.org l Spring 2024 l GP 5