HIV : Oral manifestations of human immunodeficiency virus in children

Human immunodeficiency virus (HIV) infection is considered a pandemic by the World Health Organization (WHO).

From its discovery in 1981 to 2006, acquired immunodeficiency syndrome (AIDS) has killed more than 25 million people.

HIV infects about 0.6% of the world's population. In 2005, AIDS claimed an estimated 2.4-3.3 million lives, of which more than 570,000 were children. Most of the cases are seen in sub-Saharan countries and developing nations.

Antiretroviral treatment reduces both the mortality and the morbidity rates of HIV infection, but routine access to antiretroviral medication is not available in all countries. HIV transmission in children occurs mainly through vertical transmission (mother to child).

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The risk of transmission by an infected mother occurring before or during birth (without medical intervention) is around 15-20%. Breast feeding by an infected mother increases the risk by 5-20% to a total of 20- 45%.

In a study conducted in Brazil, vertical transmission was seen in 97.5% in children. Studies in India had reported that vertical transmission is seen in 51 to 83% of children.

Oral manifestations are amongst the earliest and most important indicators of HIV infection. At present three groups of oral manifestations are defined by Greenspan et al, based on their intensity and features.

Srinivas Rao Ponnam, Gautam Srivastava, Kotaih Theruru

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