Mouth Ulcers and HIV – Understanding the Relationship and Managing Symptoms

Oral ulcers and HIV - Understanding the relationship and controlling the symptoms < E span> follows a balanced diet: a nutritious diet rich in vitamins and minerals can favor oral health in general. It may be beneficial to include mouth foods, such as soft fruits, vegetables and no n-acid dairy products.

Mouth ulcers, also known as oral ulcers or thrush, are a common condition that people living with HIV can develop. These ulcers usually appear as painful sores or open lesions in the mouth, specifically on the lips, gums, tongue, or inside of the cheeks. Although mouth ulcers can be caused by a variety of factors, they are especially common among people with HIV due to the weakened immune system associated with the infection.

The exact cause of mouth ulcers in HIV patients is not completely known, but it is believed to be mainly influenced by the virus itself and its impact on the immune system. HIV attacks and destroys CD4 cells, which are crucial for maintaining a healthy immune response. As a result, HIV-positive people are more susceptible to infections and have a reduced ability to heal wounds, including mouth ulcers.

According to a study published in the Journal of Oral Pathology and Medicine, up to 25% of people with HIV/AIDS experience mouth ulcers at some point during the course of the disease. These ulcers can persist for long periods of time and often recur frequently, causing discomfort and difficulties in everyday activities such as eating, speaking, and maintaining oral hygiene.

It is important for HIV-positive people to work closely with their healthcare professionals to treat mouth ulcers effectively. Treatment options typically focus on relieving symptoms, promoting healing, and preventing infection. This may include maintaining good oral hygiene practices, using prescribed mouthwashes or gels, and taking over-the-counter pain relievers. Additionally, antiretroviral therapy (ART) plays a crucial role in the control of HIV and can help improve immune function, reducing the frequency and severity of mouth ulcers.

Mouth Ulcers in Individuals with HIV: Causes, Symptoms, and Treatment

Causes: Mouth ulcers in people with HIV can have multiple causes. These can be viral and bacterial infections, fungal overgrowth, or even side effects from medications used to treat HIV. The weakened immune system of people with HIV makes them more susceptible to these infections and can cause mouth ulcers to come back.

Important information:

  • In people with HIV, mouth ulcers can be caused by viral, bacterial, or fungal infections.
  • The weakened immune system of people with HIV makes them more susceptible to these infections.
  • The medications used to treat HIV can also contribute to the appearance of mouth ulcers.

Symptoms: mouth ulcers in people with HIV have characteristic symptoms. They can include painful sores that appear as round or oval injuries inside the mouth. Ulcers are usually red or white and can be surrounded by a red halo. Some people may experience an ardor or tingling sensation before the appearance of ulcers. In severe cases, people may have difficulty eating, speaking or maintaining adequate oral hygiene.

Treatment: The treatment of mouth ulcers in people with HIV focuses on treating the underlying cause and relieving pain and discomfort. Antiviral, antibacterial or antifungal medications can be prescribed for specific infections. In addition, maintaining good oral hygiene, avoiding irritants such as spicy meals and using analgesics or topical ointments without recipe can help relieve symptoms. In severe cases, a healthcare professional may recommend mouthwashes with corticosteroids or other immunosuppressive therapies.

Important information:

  • The treatment of mouth ulcers in people with HIV consists in addressing the underlying cause and controlling pain and discomfort.
  • Antiviral, antibacterial or antifungal medications can be prescribed specific to treating infections.
  • Maintaining good oral hygiene and avoiding irritants can help relieve symptoms.
  • In severe cases, mouthwashes with corticosteroids or immunosuppressive therapies may be recommended.

Oral ulcers are a frequent oral manifestation in people infected with human immunodeficiency virus (HIV), the virus causing acquired immunodeficiency syndrome (AIDS). People who live with HIV/AIDS often experience greater prevalence and severity of these ulcers compared to the general population. The presence of mouth ulcers in patients with HIV can be an indication of immunosuppression and progression of the disease.

Important information:

  • Oral ulcers are an oral manifestation associated with HIV infection.
  • Seropositive persons may experience greater prevalence and severity of oral ulcers compared to the general population.
  • The presence of mouth ulcers in patients with HIV may indicate immunosuppression and disease progression.

Common Causes of Mouth Ulcers in People with HIV

A common cause of mouth ulcers in people with HIV is opportunistic infections (OI). When the immune system is weakened, it is easier for various infections to take hold and cause mouth ulcers. Opportunistic infections, such as oral candidiasis and herpes simplex virus, can cause painful ulcers that can spread and worsen if not treated properly. It is important for HIV-positive people to closely monitor their oral health and see a doctor quickly if they have any signs of opportunistic infection.

Opportunistic Infections (OIs) Associated with Mouth Ulcers in People with HIV

  1. Oral thrush: This fungal infection is caused by the overgrowth of Candida albicans, a type of yeast. It can lead to the appearance of white spots or plaques on the tongue, the inside of the cheeks and the palate, which can progress to painful ulcers. Good oral hygiene, antifungal medications, and management of underlying immunosuppression are vital to treating and preventing oral thrush in people with HIV.
  2. Herpes simplex virus (HSV): HSV infections, especially those caused by HSV-1, can manifest as recurrent mouth ulcers known as cold sores or cold sores. These ulcers are usually small fluid-filled blisters that can be painful and cause discomfort. Antiviral medications and avoidance of triggers, such as stress or sunlight exposure, may help control HSV-related mouth ulcers in people with HIV.

These are just a few examples of opportunistic infections that can cause mouth ulcers in HIV-positive people. It is essential that HIV-positive people work closely with their healthcare professionals to effectively monitor and manage their oral health. Regular dental checkups, proper oral hygiene, and prompt treatment of any oral infections can significantly reduce the occurrence and severity of oral ulcers in this vulnerable population.

Recognizing the Symptoms of Oral Lesions in Individuals with HIV

Ulcers: Mouth ulcers usually appear as round or oval sores on the inside of the mouth, including the inside of the cheeks, gums, tongue, or lips. These ulcers can vary in size, from a few millimeters to several centimeters in diameter. They may have a yellowish or grayish base covered by a white or yellowish-gray pseudomembrane, which may cause discomfort when eating, drinking, or speaking.

Note: Ulcers in people with HIV may be recurrent and take longer to heal compared to ulcers in people without HIV. Additionally, the presence of ulcers may indicate a weakened immune system and the need for additional medical evaluation and treatment.

Other lesions: In addition to ulcers, people with HIV can also develop other types of oral lesions. These include oral candidiasis, which presents as whitish spots or plaques that can be easily cleaned, or hairy leukoplakia, characterized by white, wavy or hairy lesions that are mainly seen on the sides of the tongue.

Common symptoms of mouth ulcers in people with HIV:
  • Pain or discomfort in the mouth
  • Difficulty eating or drinking
  • Sensitivity to spicy or acidic foods
  • Swelling or inflammation around the ulcers
  • Redness or irritation of surrounding tissues

It is important to note that the presence of mouth ulcers alone does not confirm HIV infection. However, if persistent or recurrent oral lesions are observed, it is essential to seek medical attention for proper diagnosis and appropriate treatment. Early detection, prompt treatment, and regular dental care can help prevent complications and maintain oral health for people living with HIV.

Complications and Challenges of Oral Ulcers in Individuals with HIV


  • Secondary infections: The presence of oral ulcers in HIV-positive people may increase the risk of developing secondary infections. Due to the weakened immune system, these ulcers can become a gateway for various opportunistic infections, such as bacterial, viral or fungal infections. This can further aggravate symptoms, prolong the healing process, and require additional medical intervention.
  • Weight loss and malnutrition: Mouth ulcers can significantly affect an individual’s nutritional intake, causing weight loss and malnutrition. The pain and discomfort caused by ulcers can make it difficult to eat solid foods, resulting in a limited diet and inadequate nutrient absorption. This can further weaken the immune system and hinder the body’s ability to fight infections.
  • Poor oral hygiene: The presence of mouth ulcers can complicate oral hygiene practices in HIV-positive people. Brushing and flossing can be painful, leading to inadequate oral care. Additionally, using certain oral hygiene products, such as alcohol-based mouthwashes, can further irritate ulcers and delay the healing process.

It is essential that people with HIV and mouth ulcers receive adequate medical care and guidance to manage complications associated with these ulcers. The surveillance of secondary infections, the application of strategies to maintain adequate nutrition and the promotion of good oral hygiene practices are crucial to prevent new complications and improve oral health and wel l-being in general. The collaboration between health professionals and patients is essential to develop an individualized treatment plan that adapts to the specific needs and challenges of each person.

Effective Treatment Options for Mouth Ulcers in HIV-positive Individuals

One of the main methods of treatment of oral ulcers in seropositive people is the use of topical medications. Topical gels that contain active ingredients such as corticosteroids or anesthetics can be applied directly on ulcers to relieve pain and favor healing. These medications reduce inflammation and numb the affected area, which allows you to eat and speak more comfortably. In addition, antiviral gels can also be used to treat any underlying viral infection, such as herpes simple herpes virus, which can contribute to the appearance of mouth ulcers in this population.

Tip: The application of topical medications with a clean cotton stick or an inguantled finger can help prevent the spread of infection and to precisely locate ulcers.

In addition to topical treatments, systemic medications can be prescribed to treat oral ulcers in seropositive people. For example, in cases where ulcers are recurring or serious, health professionals may recommend the use of oral or immunosuppressive corticosteroids. These medications are effective in reducing inflammation and suppressing the immune response that can exacerbate ulcers formation. However, it is important to keep in mind that the use of systemic medications can have potential side effects and requires close surveillance by a healthcare professional.

Did you know what? Maintaining good oral hygiene practices, such as brushing your teeth and using dental thread regularly, can help prevent the appearance of oral ulcers and promote the general oral health of seropositive persons.

Additionally, complementary therapies, such as mouthwashes containing antimicrobial agents, may be beneficial in treating mouth ulcers in HIV-positive people. These mouthwashes can help reduce the bacterial load in the mouth, prevent secondary infections, and improve overall oral health. Additionally, avoiding spicy and acidic foods, as well as tobacco and alcohol, can also help minimize the irritation and discomfort caused by mouth ulcers.

Treatment options Benefits
Topical medications (such as corticosteroid gels) Relieve pain and promote healing
Systemic medications (such as oral corticosteroids) They reduce inflammation and suppress the immune response
Antimicrobial mouthwashes They reduce the bacterial load and prevent secondary infections

Preventing Mouth Ulcers and Maintaining Oral Health in Individuals with HIV

People living with HIV often face various oral health problems, such as mouth ulcers. These painful ulcers can make it difficult to eat, speak, and maintain good oral hygiene. However, with proper prevention and care, HIV-positive people can effectively treat mouth ulcers and maintain optimal oral health.

Prevention of mouth ulcers:

  1. Practice good oral hygiene: Regular brushing with a soft-bristled toothbrush and flossing can help remove bacteria and food particles that can contribute to mouth ulcers. It may also be beneficial to use a gentle toothpaste designed specifically for sensitive mouths.
  2. Avoid irritating substances: Certain foods, such as acidic or spicy foods, as well as tobacco and alcohol, can aggravate mouth ulcers. It is advisable to avoid these substances to reduce the risk of developing ulcers.
  3. Control stress: Stress has been linked to the appearance of mouth ulcers in HIV-positive people. Engaging in stress-reducing activities, such as exercise, meditation, and counseling, can help minimize the occurrence of ulcers.

Note: Regular dental check-ups are crucial for HIV-positive people, as they can help identify and treat any oral health problems early.

Maintain oral health

  • Use mouthwashes: Antiseptic mouthwashes prescribed by dental professionals can help reduce oral bacteria and promote the healing of mouth ulcers.
  • Stay hydrated: Proper hydration can prevent dry mouth, which can worsen mouth ulcers. Drinking plenty of water throughout the day is important to maintain oral health.
  • Follow a balanced diet: a nutritious diet rich in vitamins and minerals can favor oral health in general. It may be beneficial to include mouth foods, such as soft fruits, vegetables and no n-acid dairy products.

Important: Any persistent oral ulcer or worsening must be quickly evaluated by a healthcare professional to rule out possible complications.

By incorporating these measures and preventive practices into their daily routine, people with HIV can greatly reduce the probability of developing oral ulcers. In addition, maintaining regular appointments with dental professionals is essential for continuous monitoring and management of oral health in the context of HIV.

Author of the article
Dr.Greenblatt M.
Dr.Greenblatt M.
Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont

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