Prevalence and incidence of oval lesions - the changing scene

A range of oral mucosal and periodontal lesions is associated with HIV infe ction and HIV disease progression. These are often symptomatic and require treatment in themselves, and also have a diagnostic and prognostic role in the management of the underlying HIV disease. These lesions have been broad ly divided into: (a) those strongly associated with HIV such as oral candid oses, oral hairy leukoplakia and Kaposi's sarcoma; (b) those less strongly associated such as swellings of the major salivary glands; and (c) those le ast commonly associated such as recurrent aphthous ulcers, Overall the prev alence and severity of these lesions inversely correlate with the level of immunosuppression. With the passage of time, there has been improved unders tanding of the disease pathogenesis resulting in the development of new dru gs to combat this infection. Medication has changed from monotherapy to cur rent triple combination therapy (Highly Active Anti-Retroviral Therapy), Th is review looks at the impact of changing therapy on the prevalence of the various oral lesions associated with HIV. It finds a decrease in the preval ence of the oral lesions in the era of combination therapy as compared to e arlier periods, It also shows a change in the types of lesions which predom inate with those previously placed amongst the strongly associated lesions no longer being predominant in the era of combination therapy where such tr eatment is available.