Oral lesions commonly occur with HIV-1 infection, but some reports have suggested that HAART is linked with a decrease in many secondary features of infection.
Deborah Greenspan and colleagues from the University of California, San Francisco, USA, conducted a retrospective 9-year survey of 1280 HIV-1-positive patients.
They found a six-fold increase in oral warts in those on HAART, compared with patients not given any form of anti-retroviral therapy.
|Six-fold increase in oral warts in patients given HAART.|
Patients given anti-retroviral therapy (but not HAART) had a three-fold increase risk of oral warts.
In contrast, oral candidosis (a fungal infection of the mouth), hairy leukoplakia (a white patch on the side of the tongue due to Epstein Barr virus), and Kaposi's sarcoma (a malignant proliferation of blood vessels due to another herpes virus, HHV8) decreased over the study period.
The investigators conclude that the reconstitution of the immune system might be incomplete under HAART, and that its effectiveness varies with regard to different potentially pathogenic microorganisms.
Deborah Greenspan comments, "These lesions are troublesome for the patient. They can interfere with speaking and eating, and are extremely difficult to treat".