Antiretroviral therapy for HIV infection

The prevalence of people living with HIV infection is expected to rise and these people are increasingly likely to seek care from practitioners who are not specialists in managing HIV. Dental clinicians need to be aware of changes occurring in the management of HIV infection, the increase in number and complexity of antiretroviral regimens and the potential for drug interactions with commonly prescribed drugs. For example, erythromycin, metronidazole and miconazole have potential interactions with some antiretroviral drugs that may require close monitoring, alteration of drug dosage or timing of administration. Consultation with an HIV expert is strongly recommended before starting any new medication in patients taking antiretroviral drugs. Furthermore, unusual and rare adverse effects such as peri-oral paraesthesia can occur with antiretroviral drugs.

Dental clinicians should be aware that approximately 50% of patients living with HIV/AIDS are smokers. These patients therefore have an increased likelihood of oral diseases such as periodontal disease, leucoplakia and oral squamous cell carcinoma so thorough dental examination, treatment and monitoring is required.