Active Antiretroviral Therapy ( Haart )

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Since the advent of highly active antiretroviral therapy (HAART) there has been a significant decrease in the impact of HIV associated comorbidities. The HIV status of patients can present with numerous oral manifestations, and their implications make it an essential field of study for the general dentist. However, while the decline of these comorbidities is well documented, the continued prevalence of Human Papilloma Virus (HPV) is of notable concern. The primary manifestation of HPV in the oral cavity presents as the Squamous Papilloma, commonly referred to as the oral wart. Our preconception of the lesion usually consists of a cauliflower shaped mass projecting from the buccal mucosa. But it is the possibilities of malignancy associated…show more content…
It represents 2.5% of all oral lesions and is the most frequently observed papillary lesion in the oral cavity (2). The majority of these lesions are associated with varying HPV subtypes and considerable research has been conducted to identify them. It should be noted that not all squamous papillomas have a viral etiology; however, this discussion will focus on those that do. Epidemiologically, HPV is a significant health burden worldwide as well as to the U.S population. Currently, the U.S estimated incidence of genital HPV is 5.5 million, and the prevalence of current infection is estimated at 20 million (3). Assessment of HPV infection is accomplished by HPV DNA detection tests through PCR technique. Data on infection in women is more numerous, due to the availability of standardized methods of mucosal sampling. Detection is essential in infected patients as the majority of cases can appear asymptomatic, (especially in men) with no means of detection physically or cytologically. HPV is a double stranded DNA virus of the papovavirus family containing a single molecule (2). The various subtypes are antigenically distinct yet still retain common antigenic determinants. Proliferation of the virus is dependent on the host cell’s DNA and occurs in the nuclei of the host’s epithelial cells. Expression of the viral genome comes about due to the host DNA
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