ORAL MANIFESTATIONS OF HIV INFECTION: DIAGNOSTIC VALUE AND PROGNOSTIC IMPLICATIONS (A LITERATURE REVIEW)

Oral lesions in HIV-infected patients remain important clinical markers of immunodeficiency and antiretroviral therapy (ART) effectiveness, despite the widespread implementation of ART. For this review, scientific publications from 2019–2024 were analyzed using PubMed, Scopus, Web of Science, and Google Scholar, including original research, systematic reviews, and meta-analyses. The results indicate that opportunistic oral lesions in HIV-infected individuals can be classified as fungal (candidiasis, histoplasmosis, cryptococcosis), viral (Herpes Simplex Virus, Epstein–Barr Virus, Cytomegalovirus), bacterial (staphylococcal infections, necrotizing gingivostomatitis, tuberculosis), protozoal (Entamoeba gingivalis and Trichomonas tenax), and HIV-associated neoplasms (Kaposi’s sarcoma, oral hairy leukoplakia, lymphomas). Candidiasis is the most common manifestation, frequently recurring in the oral cavity and potentially indicating progression of immunodeficiency and insufficient ART effectiveness. Viral infections are characterized by severe courses, multiple ulcers, and frequent exacerbations, especially with low CD4+ lymphocyte counts. Bacterial lesions, including necrotizing processes and oral tuberculosis, are severe in patients with profound immunodeficiency. Protozoa infections and certain viral neoplasms are rare but have diagnostic and prognostic significance. All these oral lesions serve as indicators of immunodeficiency severity, signal the need for ART adjustment, and require careful patient monitoring; their generalization may indicate progression of HIV infection to clinical stage 4. Thus, pathognomonic and recurrent oral lesions in HIV-infected patients are important diagnostic and prognostic criteria that require a systematic approach to treatment and monitoring. Future research should focus on standardizing diagnostic criteria and developing algorithms for interdisciplinary management of HIVinfected patients.