What are HIV Mouth Sores? – Let’s Find Out


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Dr Sukanya Goswami
Sukanya has done BDS. She is a dentist, a blogger, an extrovert, and a travel enthusiast. She is also a spiritual believer. When she is not working, you can find her reading books.

Mouth Sores are one of the most painful and stressful oral conditions. Often, mouth sores interfere with the normal functions of the mouth, such as speaking, chewing, and swallowing. There are several types of mouth sores; one characteristic mouth sore is an HIV mouth sore. As the name suggests, these mouth sores are a common symptom of HIV. They have a profound effect on a person’s quality of life.

HIV mouth sores are usually caused due to the weakening of the immune system. The World Health Organization has revealed that around 40-50% of the people with HIV develop mouth sores along with other oral complications.

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Treatment of HIV also helps to subside and heal the mouth sores. Moreover, it helps to strengthen the immune system. It is best to follow preventive therapies to reduce the incidence of mouth sores in patients with HIV. Today’s article will highlight the features of HIV mouth sores. Furthermore, we will look at the preventive therapies used to reduce the incidence of this oral condition.

What are HIV mouth sores?

HIV mouth sores are termed to a group of mouth ulcers or sores that develop as a result of opportunistic infections caused by a weak immune system. HIV mouth sores typically occur in patients with HIV. Its prevalence is usually around 32-46% of the people with HIV and a weak immune system.

Often, HIV mouth sores degrade the quality of life. Moreover, it can interfere with the normal functions of the mouth, such as eating, chewing, and speaking. (1) Additionally, the medications taken to treat HIV may react with the mouth sore and worsen its condition.

What are the causes and characteristics of HIV mouth sores?

Typically, HIV weakens the immune system of an individual and increases the risk of opportunistic infections. Such diseases lead to the development of a wide range of HIV mouth sores that can be associated with the following infections –

Oral herpes

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Oral herpes is typically caused by herpes simplex virus – 1, and the incidence of herpes is very high in HIV patients. Often, people with untreated HIV and herpes experience prolonged outbreaks of mouth sores in the form of cold sores. The lesion is characterized as fluid-filled blisters that develop in clusters in the mouth. Moreover, it is accompanied by high fever, fatigue, muscle aches, and swollen lymph nodes. Some patients also experience burning or tingling sensation near the sores. (2)

HIV with herpes sores are highly contagious and can spread through direct contact of saliva from the infected person. Transmission often occurs during the outbreak of the sores in the mouth.

Human papillomavirus

HPV – human papillomavirus infection is a widespread occurrence in patients with HIV. A recent study revealed that around 48% of the women with HIV in Italy had HPV infection as well.

Usually, mouth sores in such conditions develop as small whitish bumps or warts. The prime locations for the growth of mouth sores are the outer skin and inner mucosal layer of the lips. HIV with HPV mouth sores is not painful, but they may bleed easily if the patient tries to touch it or manipulate it with hands. (3)

Some of the symptoms of HIV mouth sores caused by HPV infection are –

  • Swollen tonsils
  • Sore throat
  • Difficulty in swallowing
  • Painful warts in the mouth

Aphthous ulcers

Aphthous ulcers are excruciating and develop on the soft oral mucosa of the mouth. They commonly occur in patients with HIV. Aphthous ulcers are characterized as white and gray painful mouth sores. Some of the contributing factors include –

  • Vitamin deficiency
  • Stress (4)
  • Weak immune system
  • Accidental injury to the oral tissues

Oral thrush

Fungal infections are one of the most common types of opportunistic infections experienced by HIV patients. These lesions develop as white or yellow patches on the tongue, the roof of the mouth and cheeks. Moreover, they may cause a burning sensation, loss of taste, and dry mouth. (5)

Dry mouth

Dry mouth is another common occurrence in patients with HIV that increases the risk of developing HIV mouth sores. Often dry mouth is caused as a side effect of medications used to treat HIV. The reduces salivary production in the mouth can lead to the development of painful inflammatory lesions. (6)

What is the treatment for HIV mouth sores?

Treatment of HIV mouth sores usually depends on the type of underlying cause. Some of the treatment options for HIV mouth sores are –

  • Mouth sores caused by oral herpes are treated with antiviral medications such as acyclovir. Moreover, the patients are restricted from sharing their food or utensils as this condition is highly contagious.
  • Over-the-counter creams and mouthwashes help to reduce inflammation and sores in case of aphthous ulcerations. (7)
  • HIV mouth sores caused by human papillomavirus infection require surgical removal.
  • Antifungal mouthwash and medications work well to treat mouth sores caused by a candida infection.
  • Dry mouth can be treated by increasing the water intake and chewing sugarless gums to stimulate salivary flow. Artificial salivary substitutes may be suggested in chronic cases of dry mouth. (8)

It is advised to get a full mouth examination as the dentist will be able to detect the problems in the mouth. Moreover, he will asses the severity of the mouth sores and advise appropriate treatment to manage the symptoms.

Take away message

Mouth sores are a widespread occurrence in patients with HIV. They are mainly caused by the weakening of the immune system and increased susceptibility to opportunistic infections. Several contributing factors lead to the development of HIV mouth sores. Some of them include HPV infection, oral herpes, fungal infections, and aphthous ulcerations.

Typically, HIV mouth sores develop as white gray raised blister-like lesions that burst to form ulcers in the mouth. In other cases, such as HPV related lesions form as warts in the tongue, palate, and cheeks.

Treatment usually depends on the type of cause and can be managed by appropriate medication therapy. HIV mouth sores caused by human papillomavirus require surgical removal. It is essential to see a dentist for a full mouth check-up and prevent the recurrence of HIV mouth sores.

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