Orofacial effects of antiretroviral therapies

This paper summarises some of the oral adverse effects of antiretroviral ag ents. Some are related to bone marrow suppression which may also predispose to mouth ulcers. Erythema multiforme and toxic epidermal necrolysis are es pecially well recognized in HIV disease, particularly as reactions to sulph onamides and to antiretroviral agents. Oral lichenoid reactions have been d escribed in HIV disease often relating to zidovudine use. Didanosine has al so produced erythema multiforme and not unusually induces xerostomia, again by an unknown mechanism. Xerostomia may be seen in up to one-third of pati ents taking didanosine. Taste abnormalities are common with the protease in hibitors and oral and perioral paraesthesia can be a disturbing adverse eff ect. Ritonavir in particular can give rise to circumoral paraesthesia in ov er 25% of patients. Indinavir can also produce cheilitis.