HIV Patients Taking Efavirenz (Sustiva) Experience Fewer Oral Lesions than Those on Protease Inhibitors

Sustiva Tablet

Oral lesions have an important prognostic value for HIV patients, as they may be an indicator of immune decline and disease progression. However, the prevalence of such lesions in patients receiving HAART regimens that include efavirenz (Sustiva) has not been documented.

The aim of the present study, published in the May online edition of AIDS Research and Human Retroviruses, was to establish the prevalence of oral lesions in HIV/AIDS patients undergoing efavirenz-containing HAART, and to compare it with the prevalence of such lesions in individuals receiving regimens containing protease inhibitors (PIs).

The study included 73 patients receiving antiretroviral treatment for at least for 6 months at "La Raza" Medical Center's Internal Medicine Unit in Mexico City.

To detect oral lesions, each patient underwent a detailed examination of oral soft tissues. The researchers collected data on patient sex, time of HIV seropositivity, route of infection, antiretroviral therapy type and duration, CD4 cell count, and HIV viral load.

Study subjects were classified into 2 groups were formed: 38 patients receiving efavirenz plus 2 nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), and 35 patients receiving 1 PI plus 2 NRTIs. Oral lesion prevalence was then established for each study group.

Results

• Oral lesion prevalence in the efavirenz group was lower than in the PI group (32% vs 63%, respectively; P < 0.007).

• Candidiasis (thrush) was the most prevalent oral lesion in both groups.

• Other lesions identified were:

• Herpes labialis (oral herpes simplex);
• HIV-associated necrotizing periodontitis (gum disease);
• Xerostomia (dry mouth);
• Oral hairy leukoplakia (white lesions on the sides of the tongue);
• Nonspecific oral sores.

• The highest prevalence for all oral lesions was found in the PI HAART group.

Based on these results, the study authors concluded, "HIV/AIDS patients undergoing [efavirenz-containing HAART] show a lower prevalence of oral lesions than patients undergoing [PI-containing HAART]."

Laboratorio de Patología Clínica y Experimental, División de Estudios de Postgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, México City, México.

6/09/08

Reference

SI Aquino-García, MA Rivas, A Ceballos-Salobreña, and others. Oral Lesions in HIV/AIDS Patients Undergoing HAART Including Efavirenz. AIDS Research and Human Retroviruses. May 28, 2008 [Epub ahead of print].

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