Periodontists' perspective of HIV manifestations

Human immunodeficiency virus (HIV) is a retrovirus having special affinity for the CD4 receptor molecule, which is present on the surface of T-helper lymphocytes. There are two genetically different but related forms of HIV, HIV-1 and HIV-2, that have been isolated from patients with acquired immunodeficiency syndrome (AIDS). The development of periodontal disease in HIV patients is due to its host-microbial interaction. This results in a compromised host immune system leading to the destruction of periodontal supporting structures. The first clinical signs of HIV infection are often associated with various oral and perio- dontal manifestations. HIV-associated periodontal lesions may be categorized as unusual forms of gingivitis, necrotizing periodontal diseases, and exacerbated periodontitis. These observations have led to the universal inclusion of almost all oral lesions in staging and classification schemes for HIV infection. In the last few decades, the dentists have played a paramount role in identifying and treating both common and uncommon oral and periodontal lesions in HIV-infected patients. This review aims to provide an update on the pathogenesis, re-activation of HIV, various periodontal manifestations of HIV, and recent updates on HIV management. An in depth understanding of AIDS and its oral manifestations is important for appropriate management of oral lesions in patients infected with HIV.