6th World Workshop on Oral Health and Disease in AIDS

  

Oral Dysplasia and Squamous Cell Carcinoma in Patients with HIV Infection
 
 

Oral Dysplasia and Squamous Cell Carcinoma in Patients with HIV Infection
J.A.G. BUCHANAN1, A.M. HEGARTY1, N. KALAVREZOS 2, T.A .HODGSON1, S.R. PORTER 1
Units of Oral Medicine1 and Maxillofacial Surgery2, UCL Eastman Dental Institute and UCLHT, Eastman Dental Hospital, London, UK

Introduction Following HAART introduction a relative increase in HPV-associated oral warts in HIV-infected individuals has been reported. Histopathological analysis of these lesions frequently reveals mild dysplastic features and it is suggested affected patients may be at risk of development of oral squamous cell carcinoma (OSCC).

Case series We report a case series of 7 HIV infected males presenting with oral epithelial dysplasia or frank oral squamous cell carcinoma and assess likely risk factors for oral oncogenesis, management and outcomes.

Case Age Smokes
(pack years)		 Alcohol
(units/week)		 Diagnosis HPV Geno type Management
A 49 28 3 severe dysplasia 16 Surgery
B 37 15 10 moderate/severe dysplasia Neg Surgery
C 45 Nil 2 OSCC Neg Surgery
D 45 20 25 OSCC & severe dysplasia Neg Surgery & DXT
E 42 10 21 moderate dysplasia Not typed Surgery
F 46 20 20 Mild dysplasia 6 Monitor
G 54 Nil 12 Mild dysplasia Neg Monitor

Conclusion

With the improved life expectancy associated with HAART, this case series suggests HIV-infected individuals may become increasingly susceptible to well-recognized risk factors for OSCC namely long-term alcohol and tobacco use - especially if they occur in combination with other risk factors for OSCC such as malnutrition, deprivation, poor oral hygiene and possibly HPV infection. The relatively young age of the individuals in this series concurs with the few other reports in the literature.
 
 
 
     
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