5: Immune defects and haematological defects and malignancies

5

Immune defects and haematological defects and malignancies

Human immunodeficiency virus (HIV) disease

HIV is a retrovirus transmitted sexually, via blood, or to the neonate, which has produced a global pandemic, especially affecting people in the developing world. There can be a range of orofacial complications seen in HIV disease (Figure 5.1), and in the acquired immune deficiency syndrome (AIDS) – defined as a CD4 T lymphocyte count of less than 200 cells per microlitre (µl) of blood (Table 5.1).

Table 5.1

Orofacial complications in HIV/AIDS

Viral infection Herpesviruses (Figure 5.1), and HPV mainly
EBV is a herpesvirus that can cause hairy leukoplakia (Figures 5.6, 5.7) which mainly affects margins of the tongue and is a predictor of progression to full-blown AIDS. EBV may cause lymphoma
Fungal infections Candidosis (Figures 5.25.5)
Bacterial infection Necrotizing ulcerative gingivitis/periodontitis (Figures 5.8, 5.9)
Virally-related neoplasms Kaposi sarcoma, lymphoma
image
Figure 5.1 HIV disease: chronic candidosis, and herpes simplex ulceration.

Orofacial lesions in HIV disease have been classified as follows:

• Group I: Lesions strongly associated with HIV infection

image Candidosis

erythematous Figures 5.25.5)
image
Figure 5.2 HIV disease: erythematous candidosis in the classic ‘thumbprint’ distribution.
image
Figure 5.3 HIV disease: erythematous candidosis.
image
Figure 5.4 HIV disease: erythematous candidosis.
image
Figure 5.5 HIV disease: white candidosis (pseudomembranous candidosis).
hyperplastic
thrush
image Hairy leukoplakia (EBV) (Figures 5.6 & 5.7)
image
Figure 5.6 HIV disease: hairy leukoplakia related to Epstein–Barr virus (EBV) infection.
image
Figure 5.7 HIV disease: hairy leukoplakia appears corrugated rather than hairy and can be seen in any immunocompromised patients.
image HIV-gingivitis (linear gingival erythema) (Figure 5.8)
image
Figure 5.8 HIV disease: ‘linear’ gingivitis (linear gingival erythema).
image Necrotizing ulcerative gingivitis (/>

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Jan 12, 2015 | Posted by in Oral and Maxillofacial Pathology | Comments Off on 5: Immune defects and haematological defects and malignancies
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