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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oral hairy leukoplakia occurs almost exclusively in human immunodeficiency virus (HIV)-infected patients and is predictive for the development of acquired immunodeficiency syndrome (AIDS). It presents as a white plaque with a rough surface, most commonly on the sides of the tongue. The eruption is frequently overlooked, and, because it is commonly mistaken for oral candidiasis, its true incidence is unknown. The leukoplakia is the result of permissive infection of epithelial cells by the Epstein-Barr virus. Antiviral therapy that inhibits Epstein-Barr virus replication can result in clinical improvement. Oral hairy leukoplakia provides a unique clinical model for investigations on the pathogenesis of Epstein-Barr virus infection.
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PMID:Oral hairy leukoplakia. 216 9

Skin and mucous membranes including the oral mucosa are among the preferential locations of opportunistic infections and secondary neoplasms in patients infected with the human immunodeficiency virus (HIV). Infections of the oral mucosa such as thrush occur in a high percentage of AIDS patients, patients with AIDS-related complex or HIV-seropositive individuals. The clinical appearance of the infections (herpes virus infection, periodontitis) is often marked by aggressive expansion, frequent recurrences or resistance to therapy. Oral "hairy" leukoplakia is considered to be a characteristic lesion in HIV-infected individuals. Tumors like Kaposi's sarcoma, squamous cell carcinoma and non-Hodgkin lymphoma of the oral mucosa may cause marked morbidity in AIDS patients. Such oral lesions are frequently the first indication of an HIV-infection. Dentists should be aware of the oral manifestations of HIV-infection and initiate diagnostic and therapeutic measures in the interest of the patients and for epidemiologic reasons.
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PMID:[Oral manifestations of HIV infection]. 270 Apr 12

To compare the therapeutic effects of surgical excision and orally administered acyclovir therapy on symptomatic oral hairy leukoplakia, 45 homosexual men who were seropositive for human immunodeficiency virus participated in a 3-month open-label study. In the 14 patients who had surgical excision, pain resolved in four symptomatic patients and the leukoplakia did not recur in the areas of excision. New foci of leukoplakia, however, appeared in 10 patients after 3 months. Of the 16 patients who received acyclovir therapy, 12 had a clinical regression, although recurrences were noted in all patients after 3 months. Three patients had resolution of pain while taking acyclovir; in two the pain recurred after acyclovir was discontinued. No spontaneous remissions of the leukoplakia occurred in the 15 patients who refused therapy. We conclude that surgical excision is effective in patients with symptomatic oral hairy leukoplakia.
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PMID:Comparison of the efficacy of surgery and acyclovir therapy in oral hairy leukoplakia. 280 91

To define the role of Epstein-Barr virus (EBV) in the pathogenesis of oral hairy leukoplakia, 13 human immunodeficiency virus-seropositive men with clinical and histologic evidence of oral hairy leukoplakia were enrolled in an open-label trial of orally administered acyclovir therapy (3.2 g/d for 20 days). Of six patients who received therapy, five exhibited clinical regression. Once therapy was discontinued, recurrences occurred in all responders. Among seven patients who refused therapy, no spontaneous remissions occurred. Before therapy, EBV replication within the leukoplakia was demonstrated by immunofluorescence tissue staining or electron microscopy in five patients who were studied. Human papillomavirus was not detected by immunocytochemistry or electron microscopy from tissue specimens of six patients. After therapy, biopsy specimens from two patients with complete responses revealed a normalization of histologic abnormalities and an inability to detect EBV in previously involved mucosa by immunofluorescence or in situ DNA hybridization assays. It was concluded that EBV replication within the epithelial cells of the tongue is necessary for the development of oral hairy leukoplakia.
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PMID:Regression of oral hairy leukoplakia after orally administered acyclovir therapy. 282 30

Oral "hairy" leukoplakia (OHL) is a white lesion of the oral mucosa, usually located on the lateral tongue among human immunodeficiency virus (HIV) positive acquired immunodeficiency syndrome (AIDS)-risk patients. The lesion has been reported to be associated with Epstein-Barr virus (EBV) and human papillomavirus (HPV). Twenty surgical biopsy specimens were evaluated for the presence of HPV genus-specific antigen, HPV 2/4, 6/11, and 16/18 DNA and EBV DNA by in situ hybridization employing formalin-fixed paraffin-embedded sections. Three cases exhibited immunoreactivity for HPV genus-specific antigen, with localization in cytopathically altered upper spinous layer keratinocytes. HPV 16, 18, or related DNA sequences were identifiable in a single case. Alternatively, employing an EBV long internal repeat subgenomic probe, 19 cases were found to harbor EBV DNA. In all positive cases, the hybrids were localized to upper spinous layer keratinocytes exhibiting nuclear/cytoplasmic vesiculation. It is concluded that OHL is consistently associated with EBV; furthermore, viral replication, as evidenced by DNA localization, corresponds to ultrastructural evidence of capsid and envelope assembly in the more differentiated layers of oral epithelium.
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PMID:Detection of EBV and HPV DNA sequences in oral "hairy" leukoplakia by in situ hybridization. 284 34

The oral mucosae of 66 homosexual men were examined clinically and by means of cultivation to determine the presence of Candida infection. In addition, clinically detected mucosal changes were recorded and a biopsy specimen was obtained for the histopathologic classification. A total of forty one subjects (62%) showed clinical evidence of candidiasis. Fourteen (21%) of the sixty-six men were seropositive for human immunodeficiency virus (HIV). A total of thirteen of fourteen (93%) of the seropositive men and twenty-six of fifty-two (50%) of the HIV seronegative men had culture-confirmed oral candidiasis. In the latter group, oral candidiasis was clearly correlated to cigarette smoking. Clinical mucosal changes other than candidiasis were found in forty-five of the sixty-six subjects studied. The most frequent finding was trauma resulting from biting, which was usually localized on the cheek. Leukoplakia was found in twelve of sixty-six subjects, while cauliflower-like condylomas were present in 4 persons. The results emphasize the frequent occurrence of different oral lesions in subjects seropositive for HIV and in those at high risk for HIV infection. Oral examination in search for potential early manifestations of HIV infection in homosexual men is advocated.
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PMID:Oral candidal infection as a sign of HIV infection in homosexual men. 342 96

Despite differences in the modes of transmission of human immunodeficiency virus (HIV) in Africa as compared to US and Europe, the immunologic abnormalities and clinical profile in acquired immunodeficiency syndrome (AIDS) appear to be similar. Further evidence for this observation is provided by the case of a 34-year-old African male from Burundi who developed a form of oral leukoplakia previously unseen in African AIDS patients, but resembling the so-called hairy leukoplakia found in homosexuals in California. In this African patient, the diagnosis of AIDS was established on the basis of severe opportunistic infection (meningeal cryptococcosis) together with hepatic and pulmonary tuberculosis, a severely decreased T-helper to suppressor cell ratio, and the presence of antibodies to HIV. Dermatological examination revealed several mucocutaneous lesions, including 1) candidiasis with patchy depapillation of the dorsum of the tongue and 2) discrete, chronic lesions on the lateral sides of the tongue appearing as dense, white mucosal patches about 1 cm in size. A sample of a persistent white lesion on the lateral border of this patient's tongue was submitted to light and electron microscopic examination and immunoassay. The epithelium of the lingual mucosa presented parakeratotic cells, acanthosis, and surface projections typical of "hairy" leukoplakia. The prickle cells contained pyknotic nuclei and perinuclear halos. Herpes-like virus particles were observed within the nuclei of this prickle cells and in intercellular spaces. There was no evidence of papillomavirus particles. In immunoassay, the virus particles did not react to antibodies against human herpes virus. The role of herpes virus and papillomavirus in the pathogenesis of "hairy" leukoplakia has yet to be established.
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PMID:Oral "hairy" leucoplakia in an African AIDS patient. 373 24

From January 1988 to December 1993, we identified six men with minimally invasive (stage I) squamous cell carcinoma of the anus and 10 men with anal carcinoma in situ (CIS). Of the six patients with invasive carcinoma, four were infected with human immunodeficiency virus (HIV), including one with AIDS. Of the 10 patients with CIS, eight were infected with HIV, including four with AIDS. Anal pain and bleeding were the most common symptoms of minimally invasive anal cancer and anal CIS. Anal irritation, burning, or pruritus occurred more frequently in patients with CIS, whereas anal ulcers, masses, or abscesses were more frequent in patients with minimally invasive cancer. Several patients with CIS had a discrete area of leukoplakia in the anal canal or a pigmented plaque of the anus and anal canal. These lesions were not observed in patients with minimally invasive anal cancer. The symptoms and signs of early-stage anal cancer in men at risk for developing HIV infection or men infected with HIV often resemble those of other common anorectal diseases in homosexual men. Anal cancer in HIV-infected men is not limited to those individuals with AIDS.
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PMID:Clinical presentation of minimally invasive and in situ squamous cell carcinoma of the anus in homosexual men. 852 51

This report describes a case of secondary syphilis in a patient with the human immunodeficiency virus (HIV) in whom the main clinical presentation of the disease was an extensive oral lesion. Few reports in the literature have focused on oral manifestations of syphilis in HIV-infected patients; most of these reports have dealt with a rare manifestation of secondary syphilis, the ulceronodular variety or lues maligna. However, in the case reported here the lesions were painless, smooth, white, oral plaques and papules on an erythematous base with a serpentine and reddish outline corresponding to the description of mucous patches. The differential diagnosis of this lesion may include oral squamous carcinoma, leukoplakia, erythroleukoplakia, candidosis, lichen planus, and granulomatous diseases. This case report emphasizes the importance of considering secondary syphilis in the differential diagnosis of oral lesions in HIV-infected patients, reinforces the importance of follow-up on the patient, and highlights the consideration for routine serologic testing for syphilis in all HIV-infected patients.
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PMID:Oral secondary syphilis in a patient with human immunodeficiency virus infection. 878 96

The prevalence of Epstein-Barr virus (EBV) and the recently identified Kaposi's sarcoma (KS)-associated herpesvirus (also designated human herpesvirus 8 [HHV-8]) was determined in oral lesions and oral neoplasms common to persons with human immunodeficiency virus (HIV) infection. Oral lesions were examined by polymerase chain reaction (PCR) for EBV and HHV-8 DNA and by Southern blot analysis for EBV clonality. EBV was detected by Southern blot in hairy leukoplakia lesions, in a subset of AIDS-related lymphomas, and in saliva from HIV-positive persons but not in pseudohairy leukoplakia lesions, oral aphthous ulcers, or oral KS lesions. EBV was detected, however, by PCR in most of the lesions, while HHV-8 was detected only in oral KSs. The absence of HHV-8 DNA in both the EBV-associated hairy leukoplakia lesions and in the EBV-associated AIDS-related lymphomas strengthens the etiologic relationship of EBV to these pathologies and the etiologic role of HHV-8 in KS.
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PMID:Epstein-Barr virus and human herpesvirus 8 prevalence in human immunodeficiency virus-associated oral mucosal lesions. 918 Jan 70


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