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Dental with HIV

Dental with HIV


Keys


  • Human immunodeficiency virus (HIV) infection predisposes people to certain oral health problems.

  • HIV-positive patients can receive routine dental care.

  • Obtaining and reviewing a complete medical history can help identify patients who may need personalized treatment plans based on their unique medical conditions.

  • Dentists and all staff in direct contact with patients should follow all standard precautions (e.g., wear appropriate personal protective equipment and disinfect all equipment and surfaces after each patient) for all patients.


Human immunodeficiency virus (HIV) infection remains a major public health problem in the United States and around the world. HIV is the virus responsible for acquired immunodeficiency syndrome (AIDS), a chronic disease that puts people at a greater risk of contracting opportunistic infections. HIV infection can be transmitted through contact with infected human blood or other potentially infectious body fluids of an HIV-positive person (for example, semen, vaginal / rectal secretions, breast milk, or other body fluids contaminated with visible blood).


According to surveillance data from the CDC, in 2019, more than 65% of new HIV diagnoses among adults and adolescents in the United States were attributed to male-to-male sexual contact; of the remaining HIV diagnoses that year, 23.5% were attributed to heterosexual contact and 6.8% to injectable drug use.By the end of 2019, approximately 1.2 million adults and adolescents in the United States lived with 7 or more than 37 million people around the world were living with HIV. It is estimated that one in seven HIV-infected people in the United States does not know they are infected.This is a critical gap in the ongoing effort to end the HIV / AIDS epidemic, because about 80% of new infections from HIV in the United States States are transmitted by people who do not know their HIV status or who do not receive regular care.


HIV destroys specific cells of the immune system, making infected people more vulnerable to infections from other organisms and to infection-related cancers., HIV can be controlled, but not cured, with medical treatment. Over time, without effective treatment, HIV can progress to acquired immunodeficiency syndrome (AIDS), characterized by a low CD4 + T cell count (<200 cells / mm3) or one or more opportunistic infections.


HIV infection typically begins as a brief acute retroviral syndrome that progresses to a chronic disease that, over years, gradually depletes CD4 T lymphocytes, which are essential for maintaining effective immune function. If left untreated, Progressive depletion of CD4 T cells can lead to symptomatic and life-threatening immunodeficiency. Without treatment, this advanced stage of HIV infection, known as AIDS, develops over months to years, with a duration estimated median of about 11 years.


Although there is currently no cure for HIV, with effective treatment and medical care, HIV replication can be suppressed and controlled. The medicine used to treat HIV is called antiretroviral therapy. If started soon after infection and taken every day, antiretroviral therapy can significantly extend the life of people living with HIV, keep them healthy, and significantly reduce the risk of passing the virus to others. Today, a person diagnosed with HIV, treated before the disease is very advanced, and who continues treatment can live almost as long as a non-HIV positive person.


HIV is a blood-borne pathogen, and avoiding exposure to blood and body fluids is the primary means of preventing HIV transmission in dental care. Blood contains the highest percentage of infectious viral particles, but all body fluids, secretions and excretions may contain transmissible infectious agents. During dental procedures, saliva tends to become contaminated with blood, increasing the risk of HIV transmission through saliva.


Standard precautions should be followed with all patients, regardless of whether HIV is diagnosed or not. Dental staff should use barrier precautions (for example, personal protective equipment should be removed after leaving work areas and remember that gloves should never be reused). the blood is good, the average risk of HIV transmission is about 0.3% per exposure. Dental healthcare professionals can reduce the risk of percutaneous injury by following standard precautions, having technical controls and working practices for all sharp objects and following safe practices for direct injection with potentially infectious material is considered an exposure that requires clinical evaluation.


If exposed to material known or suspected to be HIV-infected, the incident should be reported to a supervisor (if appropriate) and the exposed person should seek immediate medical attention. Antiretroviral drugs may be prescribed as prophylaxis of exposure . (PEP) within the first 72 hours of exposure to help prevent HIV infection. The sooner PEP is started, the more effective it will be.