The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.for more details please visit  www.indiandentalacademy.com

1. INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

2. At the end of the lecture the student should be able to
 Describe the morphology of HIV virus
 Describe the mode of infection
 Describe the pathogenesis of HIV
 Enlist manifestations
www.indiandentalacademy.com

3.  Non oncogenic retrovirus
 Lentivirus group III
 The HIV glycoprotein antireceptors (GP-41 and GP-
120) make a snug attachment of their specific
receptor on cell membrane
 CD4 receptors found on T4 lymphocytes and other
white cells
 Mode of HIV transmission (saliva is not significant
route)
www.indiandentalacademy.com

4. Pathogenesis of HIV infection
 After binding – internalized in to the host cell –
uncoated – viral RNA then reverse transcribed in to
linear double stranded DNA in cytoplasm –
transported to nucleus – integrated in the host cell
– transcribed in to full length RNA – leads to
genome of progeny virus or synthesis of viral gene
products
www.indiandentalacademy.com

5.  Following infection virus often enters dormant stage
2 – 15 years.
 Infected CD4 – migrates to regional lymph node –
enters circulatory system – results in widespread
dissemination – primary HIV infection or
seroconversion syndrome.
 Sign and symptoms of acute infection few days to
more than 10 weeks.
www.indiandentalacademy.com

6.  Rapid rise in plasma viremia – cytotoxic T lymphocyte
response.
 Within 6-12 weeks antibodies to HIV detectable
(Window period) .
 The diseased progressed to “asymtomatic chronic
infection with or without persistent generalized
lymphadenopathy”.
www.indiandentalacademy.com

7. Clinical features
 Asymptomatic to severe clinical illness and AIDS
 Symptomatic HIV infection k/as AIDS related
complex, characterized by development of
opportunistic infections (CD4count < 500
cells/mm3
)
 AIDS diagnosed when (CD4count < 200 cells/mm3
)
 Overwhelming opportunistic infections and death
(CD4count < 200 cells/mm3
)
www.indiandentalacademy.com

8. Group 1: strongly associated with HIV
infection
 Candidiasis :- erythematous and
pseudomembranous
 Oral hairy leukoplakia
 Kaposi’s sarcoma
 Non- Hodgkin’s lymphoma
 Periodontal disease :- LGA, NUG and NUP
www.indiandentalacademy.com

9. Group 2: less commonly associated with HIV
infection
 Bacterial infections ;- Mycobacterium avium-
intercellulare, mycobacterium tuberculosis
 Melanotic hyperpigmentation
 Necrotizing ulcerative stomatitis
www.indiandentalacademy.com

10. Group 3: seen in associated with HIV infection
 Bacterial infections :- Actinomycosis isralii, Escherichia
coli, Klebsiella pneumonia, Cat Scratch disease
 Drug reactions (ulcerative, EM, lichenoid reaction,
toxic epidermolysis)
 Epithelioid angiomatosis
 Fungal infections other than candidiasis :-
Cryptococcus neoformans, Geotrictum candidum,
Histoplasma capsulatum, zygomycosis, Aspergillus
flavus
www.indiandentalacademy.com

11.  Neurological disturbances :- facial palsy, Trigeminal
neuralgia
 Recurrent apthous stomatitis
 Viral infections :- HSV 1, VZV, CMV, Molluscum
contagiosum
 Thrombocytopenic purpura
 HIV associated salivary gland disease
www.indiandentalacademy.com

12.  Virus based tests
1. Viral culture
2. PCR
3. P24 antigen detection
 Anti HIV antibody tests
1. ELISA/immunofluorescence
2. Western blot analysis
www.indiandentalacademy.com

13.  Immunological tests and surrogate markers
1. CD4+ T cell count
2. CD4/CD8 T cell ratio
 Salivary tests
1. HIV IgG antibody capture assay
www.indiandentalacademy.com

14.  Morphology of HIV virus
 Mode of infection
 Pathogenesis of HIV
 Manifestations
www.indiandentalacademy.com

15.  Text Book of Microbiology Ananthanarayan R 7th
Edition
 Text book of oral pathology Shafer's, 5 & 6th
edition
 Color Atlas of Oral Diseases Cawson, R. 2nd
edition
 Oral and Maxillofacial Pathology Neville, Brad W.
2nd
 Lucas’s Pathology Of Tumor’s of the Oral Tissues
 Cawson, R. A., Bennie, W. H 5th
edition
www.indiandentalacademy.com

16. Thank You
www.indiandentalacademy.com