Oral Manifestations of STIs Flashcards
What occurs during stage 3 HIV?
Immune system loses the struggle to contain HIV, for 3 reasons:
- Lymph nodes and tissues become damaged
- HIV mutates and becomes more pathogenic, stronger and more varied, leading to more T helper cell destruction
- Body fails to keep up with replacing T helper cells that are lost
Symptomatic stage
What is congential syphillis, and what complications may arise from this?
In uterus transmission of Treponema Pallidum to baby after 3 months of pregnancy.
Hutchinson’s teeth (teeth abnormalities) occuring few years after birth.
How long after infection does tertiary syphillis occur and what percentage of syphillis patients experience this?
3-30 years later
Around 30%
What occurs during stage 2 HIV?
- Lasts for ten years and is free from major symptoms although there may be swollen glands
- HIV in peripheral blood drop but still infectious and detectable
- Lots of T helper cells are infected and die; lots of virus is produced
Clinically asymptomatic stage
What occurs during stage 4 HIV?
Immune system becomes more and more damaged, illnesses that present become more severe leading eventually to an AIDS diagnosis
Acquired immune deficiency syndrome
What type of infection causes genital herpes?
Viral (HSV2)
Describe what you may expect to see in a patient with primary syphilis
- Chancre lesions (very infectious painless ulcer on genitals or around mouth that last for 2-6 weeks then heal)
- Potentially swollen lymph nodes
What occurs during stage 1 HIV?
Primary HIV infection
- Short flu like symptoms
- Large amount of HIV in peripheral blood
- Immune system begins to respond by producing HIV antibodies and cytotoxic lymphocytes (seroconversion)
Why does HIV found in the saliva not transmit the virus to other people?
Saliva doesn’t transmit HIV due to its antibodies
What is the difference between HIV1 and HIV2?
- Still both cause HIV
- HIV1 more common
- HIV2 seen in west Africa which is weaker, less infective and lower death rate
What type of infection causes Genital Warts?
Viral (Human Papiloma Virus)
What is the treatment of syphillis?
As bacterial use of ABX such as penicillin.
Alternatives such as tetracyclines and erythromycin
What type of infection causes Hep B?
Viral
What may occur to a patient with a CD4 count of less than 500?
Opportunitic infections arise
What type of infection causes Syphilis?
Bacterial
What may result of tertiary syphillis?
Life-threatening damage to brain, nerves, eyes, heart, bones, skin
Or life-threatening damage to blood vessels causing stroke, heart disease, dementia, paralysis, blindness or deafness
Describe what you may expect to see in a patient with secondary syphilis
- Non-itchy rash which is highly infectious on trunk and extremities
- Sore throat lasting several weeks
- General flu like symptoms
What may occur to a patient with a CD4 count of less than 200?
CD4 < 200 + clinical signs = AIDS
[200 is the critical value for CD4]
What type of infection causes Gonorrhoea?
Bacterial
What are the different periodontal conditions that can arise from HIV?
Linear gingival erythema
Acute necrotising ulcerative gingivitis (ANUG)
Necrotising ulcerative periodontitis (NUP)
What are some oral lesions strongly associated with HIV? (5)
- Candiasis
- Oral hairy leukoplakia
- Kaposi sarcoma
- Periodontal disease
- Non-Hodgkins Lymphoma
How can the microorganism that causes syphillis enter the body?
Treponema Pallidum penetrates through intact mucosa or abraded skin
- Sexual contact
- Through lesions
- IV drug use
What are the most infective stages of syphillis?
Primary and secondary stage
What are some signs of Kaposi sarcoma as a result of HIV?
Long-standing singular/multiple neoplasm
That is red/purple
That is flat or nodular
On palate or gingivae.
Affects blood vessels so present in the whole body but only visible in the mouth.
Aetiology HHV8
What is a normal CD4 range?
400-800
If a patient has stable HIV (low viral load and high CD4) what treatment will they be on?
HAART (Highly Active Anti-retroviral Therapy)
What microorganism causes syphilis?
How can this microorganism be seen in a lab?
Treponema Pallidum (causative bacteria)
Visible through UV light using anti-treponema antibodies
How does HIV infect T helper cells?
- HIV attaches itself to the CD4 cell-surface receptor molecules on its surface to enter
- Once inside, HIV replicates and the replicas go to infect other cells, which stop working or are destroyed
- The immune system kills HIV and HIV-infected cells
What type of infection causes Chlamydia?
Bacterial
What bodily fluids transmit HIV?
- Blood
- Semen
- Vaginal secretions
- Breast milk
How do you manage a patient with syphilis who has come to your dental practice?
Refer to sexual health clinic
Observe confidentiality
Partners will need to informed/tested
