Role of the dental surgeon in the early detection of adults with underlying HIV infection / AIDS

  1. Julián Campo Trapero 1
  2. Jorge Cano Sánchez 1
  3. Jorge del Romero 2
  4. Víctoria Hernando 3
  5. Julia del Amo Valero 3
  6. Santiago Moreno Guillén 4
  1. 1 Department of Medicine and Orofacial Surgery. School of Dentistry. Complutense University. Madrid
  2. 2 Sandoval STI Clinic. Community of Madrid
  3. 3 National Epidemiology Center. Carlos III Health Institute
  4. 4 Department of Infectious Diseases. Ramón y Cajal Hospital. Madrid (Spain
Medicina oral, patología oral y cirugía bucal. Ed. inglesa

ISSN: 1698-6946

Year of publication: 2012

Volume: 17

Issue: 3

Pages: 11

Type: Article

DOI: 10.4317/MEDORAL.17527 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Medicina oral, patología oral y cirugía bucal. Ed. inglesa

Sustainable development goals


A review is made of the late diagnosis of human immunodeficiency virus (HIV) infection, a subject of growing interest in public health. It has been estimated that in Europe 30% of all HIV-infected people are unaware of their seropositive condition, and this in turn is associated with a poorer long-term disease prognosis and an increased risk of transmission to other individuals. The role of the dental surgeon in this context could be of great importance, since there are many oral lesions that can suggest the existence of underlying infection. The study also addresses the controversial subject of rapid HIV testing, and whether these tests should be performed on a routine basis in the dental clinic, or whether it is preferable to refer the patient to a specialized center.

Bibliographic References

  • Pérez-Hoyos, S, Ferreros, I, del Amo, J, Muga, R, del, Romero, de Olalla, PG. (2006). Survival and progresión to AIDS in a seroconverter cohorte in the post-highly active antirretroviral therapy era: effectiveness goes on. AIDS. 20. 289
  • Gatell, JM, Zulaica, D, Robledo, T, Del Romero, J. (2010). Como promover y facilitar el diagnóstico precoz de la infección por el VIH-1; Papel de los odontólogos. Cient Dent. 7. 65
  • Delpierre, C, Dray-Spira, R, Cuzin, L, Marchou, B, Massip, P, Lang T et, al. (2007). Correlates of late HIV diagnosis: implications for testing policy. Int J STD AIDS. 18. 312
  • Hamers, FF, Phillips, AN. (2008). Diagnosed and undiagnosed HIV-infected populations in Europe. HIV Med. 9. 6-12
  • Marks, G, Crepaz, N, Janssen, RS. (2006). Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 20. 1447
  • (2010). Vigilancia epidemiológica del VIH en España. Valoración de los nuevos casos de VIH en España a partir de los sistemas de notificación de las CCAA. Periodo 2003-2009. Ministerio de Sanidad, Política social e igualdad. Madrid.
  • Sobrino-Vegas, P, García-San Miguel, L, Caro-Murillo, AM, Miro, JM, Viciana, P, Tural, C. (2009). Delayed diagnosis of HIV infection in a multicenter cohort: Prevalence, risk factors, response to HAART and impact on mortality. Curr HIV Res. 7. 224
  • Gazzard, B, Clumeck, N, d’Arminio Monforte, A, Lundgren, JD. (2008). Indicator disease-guided testing for HIV-the next step for Europe?. HIV Medicine. 9. 34-40
  • Antinori, A, Coenen, T, Costagiola, D, Dedes, N, Ellefson, M, Gatell, J. (2011). Late presentation of HIV infection: a consensus definition. HIV Med. 12. 61
  • Owens, DK, Sundaram, V, Lazzeroni, LC, Douglass, LR, Tempio, P, Holodniy, M. (2007). HIV testing of at risk patients in a large integrated health care system. J Gen Intern Med. 22. 315
  • Chou, R, Huffman, LH, Fu, R, Smits, AK, Korthius, PT, US Preventive Services Task, Force. (2005). Screening for HIV: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 143. 55-73
  • Branson, BM, Handsfield, HH, Lampe, MA, Janssen, RS, Taylor, AW, Lyss, SB. (2006). Revised recommendations for HIV testing of adults, adolescents and pregnant women in heath care settings. MMWR Recomm Rep. 55. 1-17
  • (2007). World Health Organization (WHO).Guidance on provider-initiated HIV testing and counselling in health facilities.. World Health Organization. Geneva, Switzerland.
  • (2008). UK National Guidelines for HIV testing 2008.. British HIV Association, British Association of Sexual Health and HIV British Infection Society. London.
  • Qaseem, A, Snow, V, Shekelle, P, Hopkins, R, Owens, DK. (2009). Clinical Efficacy Assessment Subcommittee, American College of Physicians. Screening for HIV in Health Care Settings: A guidance statement from the American College of Physicians and HIV Medicine Association.. Ann Intern Med. 150. 125
  • (2010). ECDC Guidance. HIV Testing: increasing uptake and effectiveness in the European Union.. European Centre for Disease Prevention and Control. Stockholm.
  • Sanders, GD, Bayoumi, AM, Sundaram, V, Bilir, SP, Neukermans, CP, Rydzak, CE. (2005). Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy. N Engl J Med. 352. 570
  • (2009). HIV infection screening in France Screening Strategies. Haute Autorité de sante. Saint-Denis La Plaine CEDEX.
  • Moreno, S, Ordobas, M, Sanz, JC, Ramos, B, Astray, J, Ortiz, M. (2010). Prevalencia de infección por VIH no diagnosticada en la población de Madrid: evidencia de la necesidad de programas de diagnóstico eficaces. II Congreso Nacional de GESIDA, 30 Nov 2010. Enfermedades Infecciosas y Microbiología Clínica. 28.
  • (2012). National Center for Health Statistics National Health and Nutrition Examination Survey (NHANES) 1999-2004. CDC/National Center for Health Statistics. Atlanta.
  • Vernillo, AT, Caplan, AL. (2007). Routine HIV Testing in Dental Practice: Can we cross the rubicon?. J Dent Educ. 71. 1534
  • Shiboski, CH, Patton, LL, Webster-Cyriaque, JY, Greenspan, D, Traboulsi, RS, Ghannoum, M. (2009). Oral HIV/AIDS Research Alliance, Subcommittee of the AIDS Clinical Trial Group. The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints. J Oral Pathol Med. 38. 481
  • Glick, M, Muzyka, BC, Lurie, D, Salkin, LM. (1994). Oral manifestations associated with HIV-related disease as markers for immune suppression and AIDS. Oral Surg Oral Med Oral Pathol. 77. 344
  • Patton, LL, McKaig, RG, Eron JJ, Jr, Lawrence, HP, Strauss, RP. (1999). Oral hairy leukoplakia and oral candidiasis as predictors of HIV viral load. AIDS. 13. 2174
  • Pindborg, JJ. (1989). Classification of oral lesions associated with HIV infection. Oral Surg Oral Med Oral Pathol. 67. 292
  • Ramírez-Amador, V, Esquivel-Pedraza, L, Sierra-Madero, J, Anaya-Saavedra, G, González-Ramírez, I, Ponce-de-León, S. (2003). The Changing Clinical Spectrum of Human Immunodeficiency Virus (HIV)-Related Oral Lesions in 1,000 Consecutive Patients: A 12-Year Study in a Referral Center in Mexico. Medicine (Baltimore). 82. 39-50
  • Greenspan, D, Gange, S, Phelan, J, Navazesh, M, Alves, ME, MacPhail LA et, al. (2004). Incidence of oral lesions in HIV-1-infected women: reduction with HAART. J Dent Res. 83. 145
  • Greenspan, D, Canchola, AJ, MacPhail, LA, Cheikh, B, Greenspan, JS. (2001). Effect of highly active antiretroviral therapy on frequency of oral warts. Lancet. 357. 1411
  • Classification and diagnostic criteria for oral lesions in HIV, infection. (1993). EC-Clearinghouse on oral problems related to HIV infection and WHO collaboration centre on oral manifestations of the immunodeficiency virus. J Oral Pathol Med. 22. 289
  • Bhayat, A, Yengopal, V, Rudolph, MJ, Nemutandani, MS. (2008). Predicting HIV in a public dental facility using Group I Oral Lesions. SADJ. 63. 538
  • Itula, PF, Mackenzie, SB, Lewis, K, Mortimer, PP. (1997). Orofacial manifestations and seroprevalence of HIV infection in Namibian dental patients. Oral Dis. 3. 51
  • Robinson, PG, Challacombe, SJ, Sheiham, A. (1998). Oral examination: a screening tool for HIV infection?. Sex Transm Inf. 74. 345
  • Bhayat, A, Yengopal, V, Rudolph, M. (2010). Predictive value of group I oral lesions for HIV infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 109. 720
  • Kaplan, JE, Benson, C, Holmes, KH, Brooks, JT, Pau, A, Masur, H. (2009). Centers for Disease Control and Prevention (CDC). National Institutes of Health, HIV Medicine Association of the Infectious Diseases Society of America.Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. MMWR Recomm Rep. 58. 1-207
  • Glick, M. (2005). Rapid HIV testing in the dental setting. J Am Dent Assoc. 136. 1206
  • Debattista, J, Bryson, G, Roudenko, N, Dwyer, J, Kelly, M, Hogan, P. (2007). Pilot of noninvasive (oral fluid) testing for HIV within a clinical setting. Sex Health. 4. 105
  • Wesolowski, LG, MacKellar, DA, Facente, SN, Dowling, T, Ethridge, SF, Zhu, JH. (2006). Post-marketing surveillance of OraQuick whole blood and oral fluid rapid HIV testing. AIDS. 20. 1661
  • Hunt, AJ, Connell, J, Christofinis, G, Parry, JV, Weatherburn, P, Hickson, FC. (1993). The testing of saliva samples for HIV-1 antibodies: reliability in a non-clinic setting. Genitourin Med. 69. 29-30
  • Bhore, AV, Sastry, J, Patke, D, Gupte, N, Bulakh, PM, Lele, S. (2003). Sensitivity and specificity of rapid HIV testing of pregnant women in India. Int J STD AIDS. 14. 37-41
  • Patton, LL, Santos, VA, McKaig, RG, Shugars, DC, Strauss, RP. (2002). Education in HIV risk screening, counseling, testing and referral: survey of U.S. dental schools. J Dent Educ. 66. 1169