Epidemiologic data indicate that the prevalence of HIV-2 infections in persons in the United States is extremely low. However, when HIV testing is indicated, tests for antibodies to both HIV-1 and HIV-2 should be obtained if epidemiologic risk factors for HIV-2 infection are present, if clinical evidence exists for HIV disease in the absence of a positive test for antibodies to HIV-1, or if HIV-1 Western blot results exhibit the unusual indeterminate pattern of gag plus pol bands in the absence of env bands.
Infection with human immunodeficiency virus HIV predisposes people to certain oral health problems. HIV-positive patients can receive routine dental care.
Careful medical histories can capture insight about patients to help identify those who require treatment plans adapted to their unique medical condition s.
Dentists and all staff with direct patient contact should follow Standard Precautions with all patients. Introduction Human immunodeficiency virus HIV destroys specific cells in the immune system, rendering infected people more susceptible to infection with other organisms and infection-related cancers.
With treatment, this late stage of infection, known as acquired immunodeficiency syndrome AIDSdevelops over months to years with an estimated median time of approximately 11 years.
The medication used to treat HIV is termed antiretroviral therapy. When initiated early after infection and taken every day, antiretroviral therapy can dramatically lengthen the lives of those with HIV, keep them healthy, and greatly lower their chance of transmitting the virus to others.
Today, a person who is diagnosed with HIV, treated before the disease is far advanced, and stays on treatment can live a nearly as long as someone who does not have HIV.
The serologic tests currently available are both highly sensitive and specific. Since rapid antibody assays are less able to detect HIV in the first three months after HIV-exposure, follow-up testing after a negative result from a rapid antibody assays should be conducted to verify results.
Dental personnel should wear barrier precautions e. Protective equipment must be removed after leaving work areas, and remember that gloves are never to be reused.
Dental Care Dental health care personnel should strive to create a safe, welcoming and nonjudgmental environment for all patients in order to encourage on-going dental care and as a component of providing equitable care as articulated by the ADA House of Delegates policy on Patient Safety and Quality of Care Trans.
Since HIV may be asymptomatic and may go unrecognized, standard precautions for infection control should be observed for all patients.
Additionally, some antiretroviral agents can reduce salivary output, increasing the risk of dry mouth. In HIV-infected children, the most commonly reported lesion is oral candidiasis, particularly the pseudomembranous, erythematous, and angular cheilitis variants.
Increased rates of viral infection also lead to higher rates of infection-related precancerous lesions such as oral hairy leukoplakia, oral warts, or oral cancer. The gingival and periodontal diseases associated with HIV in children are linear gingival erythema, necrotizing stomatitis, and in 2.
Additionally, long-term use of highly active antiretroviral therapy may be associated with dysregulation of calcium homeostasis, bone loss, or diabetes mellitus and dyslipidemia, which may predispose patients to periodontal disease. These include candidiasis particularly angular cheilitis, erythematous candidiasis, and pseudomembranous candidiasisbartonellosis, cryptococcosis, cryptosporidiosis, and histoplasmosis.
Opportunistic viral infections may predispose patients to other conditions: If any oral manifestations of HIV are present, the first priority is to relieve pain and treat infections. Prevention is even more important for HIV-positive patients, who are more susceptible to oral disease.
All dental practices should be able to provide routine dental care for adult or pediatric HIV-positive patients. Nearly all patients with HIV are able to tolerate routine dental care and procedures, including oral surgery. HIV and antiretroviral therapies may be associated with abnormal bleeding, glucose intolerance, or hyperlipidemia, which may be identified through consultation with the patient and their physician.
Preoperative scaling may be performed to help reduce the risk of postoperative complications. All procedures must be performed in a manner to minimize bleeding and avoid bringing oral pathogens into the deeper fascial planes and oral spaces. Accessed November 28, Centers for Disease Control and Prevention.
Detection, Counseling, and Referral.
Oral manifestations of HIV disease. Top HIV Med ;13 5: Oral manifestations in human immunodeficiency virus infected children in highly active antiretroviral therapy era. J Oral Pathol Med ;38 8: Basic Expectations for Safe Care. Centers for Disease Control and Prevention; Current Policies Adopted — Patient Safety and Quality of Care Trans.
Accessed November 29, The Food and Drug Administration (FDA) has recommended that all donated blood be screened for antibodies to human immunodeficiency virus type 2 (HIV-2) beginning no later than June 1, This article provides CDC recommendations for the diagnosis of HIV . Human immunodeficiency virus 1 Human immunodeficiency virus 2 The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that causes HIV infection and over time acquired immunodeficiency syndrome (AIDS).
evaluation of rapid diagnostic tests for the detection of human immunodeficiency virus types 1 and 2, hepatitis b surface antigen, and syphilis in ho chi minh city, vietnam. Acquired Immunodeficiency Syndrome (AIDS): A group of signs and symptoms, usually of severe infections, in a person who has human immunodeficiency virus (HIV).
Antibodies: Proteins in the blood that the body makes in reaction to foreign substances, such as bacteria and viruses. Efforts to prevent transmission of human immunodeficiency virus type 1 (HIV-1), particularly through the blood supply, led to the rapid development in of diagnostic tests for HIV-1 antibodies.
In , a second virus causing the acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus type 2 (HIV-2), was discovered and found. The second-generation HIV test added recombinant antigens, and the third-generation HIV tests included IgM detection, reducing the test-negative window to approximately 3 weeks postinfection.
Fourth- and fifth-generation HIV assays added p24 antigen detection to the screening assay, reducing the test-negative window to 11 to 14 days.