Symptoms of HIV in the Mouth

There are oral manifestations of HIV in all three of HIV disease's symptomatic stages. They are most serious once HIV disease has advanced to its third stage (symptomatic HIV) and occur throughout this stage and the fourth stage of HIV disease, AIDS. Symptoms of HIV disease that appear in the mouth, as is the case with other symptoms, have a number of different causes (bacterial, viral, fungal) and therefore a number of different treatments

Acute HIV Infection

• According to the authors of "HIV Infection in Primary Care" by R. Michael Buckley and Stephen J. Gluckman, there are a number of oral symptoms of acute HIV infection, including ulcerations, sore throat, swelling of the pharynx and thrush, a fungal infection. Some people experience no symptoms during acute infection, and some people's symptoms are so mild that they go unnoticed.

  The symptoms of acute HIV infection generally appear within two to four weeks after infection and clear up within a month. The most important thing to remember about the symptoms of acute HIV infection is that they are non-diagnostic; this means that even people who seek out medical treatment for these symptoms will not be diagnosed with HIV on the basis of symptoms alone.

Asymptomatic HIV

• After acute infection, HIV enters an asymptomatic phase. During this stage, which lasts for an average of 10 years, there are no symptoms of HIV, in the mouth or elsewhere. Because of this and the generally mild nature of the symptoms of acute HIV infection, the only way to know one's HIV status before HIV disease advances is to be tested.

  HIV testing is widely available and simple, and knowing one's status allows for appropriate measures to be taken to protect others and oneself. HIVTest.org can help people learn more about HIV testing and to locate testing centers; please see Resources below.

Symptomatic HIV

• A number of symptoms of HIV-disease may occur in or affect the mouth during symptomatic HIV, the third stage of the illness. Symptomatic HIV lasts between one and three years before AIDS develops, and symptoms tend to be either chronic or recurring.

  According to HIV-Symptoms.info, symptoms that may involve the mouth or the surrounding organs include breathlessness and a dry cough. More directly, the mouth may be affected by fungal infections, including thrush, a type of oral fungus that causes white plaques and sometimes red patches in the mouth, according to HIV InSite.

AIDS

• During AIDS, the fourth and last stage of HIV disease, a number of infections, including viruses, fungi and bacteria, can lead to oral symptoms. These can cause lesions or blisters, or lead in some cases to damage or destruction of oral tissues.

  In addition to thrush, other fungi causing oral symptoms in AIDS include histoplasmosis and Cryptococcus neoformans. Both lead to ulcerations of the mouth; histoplasmosis on muscosal tissues and Cryptococcus neoformans on the hard palate, according to HIV InSite.

  Among the viruses causing symptoms in AIDS are herpes viruses, including cold sores, which can be particularly severe in people with weakened immune systems. Also possible is oral involvement of herpes zoster, or shingles, which causes pain and rash with blisters and which may affect the mouth or nearby areas of the face.
  Cytomegalovirus, another herpes virus, may lead to necrotic lesions in the mouth, according to HIV InSite. Human herpes virus-4, also known as Epstein-Barr, may lead to oral hairy leukoplakia, white lesions that appear to be hairy and that are found along mucosal tissues.

  Human papilloma virus (HPV) may lead to oral lesions during AIDS.

  Bacterial infections in the mouth during AIDS can lead to both necrotizing ulcerative periodontitis (NUP) and linear gingival erythema (LGE). According to HIV InSite, both can lead to a loss of soft tissue and bone in the mouth, regardless of the state of a person's oral hygiene.

  Cancers may occur in the mouth during AIDS, including Kaposi's sarcoma and lymphomas. Kaposi's sarcoma leads to lesions that are generally purple but may also be blue or red; according to HIV InSite, these may ulcerate or become infected. Lymphoma in the mouth appears as painless swelling which, according to HIV InSite, may ulcerate.

Treatment

• Treatment for oral conditions associated with HIV disease varies based on the specific root of the problem. Many conditions respond positively to treatment with antiretroviral drugs, those used in the general treatment of HIV disease. Others, however, may need to be targeted more specifically with agents like antibacterial, antiviral, antifungal and antiparasitic drugs. The treatment of any oral manifestation of HIV will need to be determined in conjunction with a health-care professional to ensure that it will be effective and not lead to negative interactions with other drugs.