There are many symptoms of HIV that present in the mouth. Approximately 90 percent of HIV-positive patients will experience at least one oral disorder, according to TheBody.com, a compendium of knowledge on HIV and AIDS. These oral conditions may be the first signs that lead physicians to ask the patient to undergo HIV testing. The conditions can be divided into four categories: abnormal cell growth, viral infections, fungal infections and bacterial infections.
Abnormal Cell Growth
Abnormal cell growth in HIV patients is usually related to Kaposi’s sarcoma or lymphoma, according to TheBody.com. Kaposi’s sarcoma is the most common cancer associated with HIV and AIDS. Usually Kaposi’s sarcoma presents on the skin, but 50 percent of patients experience Kaposi’s sarcoma in the oral cavity. The sarcoma looks like oral patches and swellings. These lesions are red or purple and can be flat or bumpy.
Lymphomas are large growths of the lymph nodes. These are not as common as Kaposi’s sarcoma. The mass is usually present on the mouth or near the tonsils. These small lumps can interfere with swallowing or chewing.
Oftentimes, patients with HIV or AIDS can be infected by viruses. These viruses can present with oral sores. The two common viral infections in HIV patients are herpes virus and hairy leukoplakia. Herpes is a virus that can cause red sores on the roof of the mouth, as reported by the National Institute of Dental and Craniofacial Research (NIDCR). Herpes sores can be painful and are contagious. The sores can appear outside of the mouth and lips as well. If they are outside of the oral cavity, the sores are called fever blisters.
Hairy leukoplakia is caused by the Epstein-Barr Virus (EBV) and, according to the NIDCR, is a common oral lesion found in AIDS patients. The condition presents as white patches on the tongue that do not wipe away. These patches can be very thick and are described as hair-like. Hairy leukoplakia is usually not painful and is not contagious.
The most common fungal infection associated with HIV is Candidiasis, or oral thrush. This condition is a yeast infection of the mouth or genital area that is associated with HIV infections, as reported by Drugs.com. The disease is characterized by an inflammation of the tongue and mouth. There is also a thick white film on the affected areas. Any patient with HIV can be diagnosed with Candidiasis, but the disease is usually found in patients with CD4 lymphocyte (a kind of white blood cell) counts of less than 200.
Bacterial infections cause an inflammation of the gums called gingivitis. Gingivitis can occur in normal individuals, but HIV-positive patients usually contract the more severe forms of the disease, according to TheBody.com. Examples of these severe bacterial infections include necrotizing ulcerative periodontitis (NUP) and linear gingivitis erythema (LGE).
NUP is a painful infection that can cause spontaneous bleeding. NUP rapid destroys the gum and underlying bone. The patient usually experiences what has been described as deep jaw pain.
LGE is described by TheBody.com as an infection of the teeth and gums that presents with a red line limited to the area where teeth and gum meet. LGE can cause bleeding and may be confused with normal gingivitis. LGE has been reported to lead to NUP.