GINGIVAL ULCERATION IN HIV-INFECTION - A CASE SERIES AND CASE-CONTROLSTUDY

All cases of HIV-associated gingival ulceration seen at a dedicated de ntal clinic in a 5-year period were reviewed and compared against othe r patients attending the clinic. 94 (7.1%) of 1308 patients had 146 ep isodes of gingival ulceration. 89 patients had 140 episodes similar to acute necrotising ulcerative gingivitis (ANUG) and responded well to conventional treatment for ANUG. The cases were compared with 269 cont rols in logistic regression. Gingival ulceration was associated with o ral candidiasis, lower age and lack of AIDS diagnosis possibly due to a protective effect of co-trimoxazole medication. 5 patients with neut ropenia had extensive ulceration without the microflora of ANUG. Histo pathology, viral and bacterial culture revealed non-specific changes. The ulcers did not respond to the treatment regimen for ANUG but respo nded to treatment of their neutropenia. Gingival ulceration is not com mon in HIV infection. Most cases resemble severe ANUG. It is more freq uent in younger people, those with oral candidiasis and without AIDS. Co-trimoxazole may be protective. A minority of cases with ulceration and associated neutropenia resembled the non-specific oral ulceration associated with HIV.