The effects of HIV-1 on oral health and the role of dentists in HIV-1 testing and early diagnosis
The growing numbers of HIV-1 infected individuals in the past thirty years have increasingly become a global concern. The virus has cost us more than 20 million lives since its identification in the early 1980s. HIV compromises the health of the infected individuals by decreasing CD4+ T helper lymphocytes, a crucial component of the immune system. The body implements cellular and humoral immune responses in an attempt to fight the infection. This chronic infection can persist for weeks, or even over a decade until the immune system is finally overcome. The condition can advance to Acquired Immunodeficiency Syndrome (AIDS), which manifests through life-threatening opportunistic infections and cancers. This fatal disease has many routes of transmission: sexual, injection drug use, and mother-to-child. The clinical signs of HIV-1 infection are often overlooked because it can be nonspecific such as, fever, muscle soreness, and joint pain. However, one area of common HIV-1 manifestations is in the oral cavity. Oral mucosa is a natural habitat for many microorganisms. It can serve as a delicate expression of the body's immune status. For example, oral lesions and periodontal conditions are observed in patients with low CD4 T-cell count, corresponding with the decrease in immune defense mechanism during HIV-1 infection. Dentists can help in ameliorating the HIV-1/AIDS pandemic by using their expertise to identify oral signs of the deadly infection. This review aims to evaluate the effects of HIV-1 infection on oral health and to then examine how dentists can play a crucial role in HIV-1 testing and early diagnosis. Currently, 2.7 million new HIV-1 infections occur per year. High active antiretroviral therapy has improved many lives of those afflicted with this condition and will continue to do so. However, the key to ending this HIV-11AIDS pandemic is through education, early diagnosis and the cooperation between the general population and the health care providers.
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