High frequency of multiple HPV types detection in Fanconi anemia patients oral swabs.

BACKGROUND: Fanconi anemia (FA) is a rare genetic disease usually characterized by bone marrow failure and congenital malformations. The risk of development of malignancies in the oral cavity of FA patients, such as squamous cell carcinoma (SCC), increases significantly after a hematopoietic stem cells transplant (HSCT), and may also be linked with the presence of human papillomavirus (HPV) infections in the oral cavity. We investigated the prevalence and the HPV genotypes in oral mucosa of Brazilian FA patients. METHODS AND RESULTS: Oral swabs of 49 FA patients were collected. The median age of patients was 20 years (range 5-44) and 57% were over 18 years. Oral lesions were present in 20% of all patients, being 90% leukoplakia. HPV DNA was detected in 28% (14/49) of patients, and one of them also reported genital HPV lesions. Sixty-seven percent of all patients had undergone HSCT, including 12 patients (86%) of those with HPV results. Multiple HPV types were detected in 78% and 71% of HPV samples by Sanger sequencing and reverse hybridization methods, respectively. The most prevalent HPV types detected were 6, 11, 18, and 68. CONCLUSIONS: HPV prevalence in the oral mucosa of the assessed FA patients was higher than reported in the general population. Additional studies with collection of sequential samples are needed to know the natural history of the presence of multiple HPV types in these individuals and its association with the development of tumors, to evaluate the implementation of preventive measures, such as vaccination, and to guide early treatment.

Antiviral drug review: a guide to clinicians

Over the past forty years, there has been a great advance in antiviral infections treatment. The discovery of acyclovir in 1977 paved the way to new antiviral drugs. Other nucleoside analogues such as valacyclovir, penciclovir, famciclovir, ganciclovir, valganciclovir, cidofovir and foscarnet were made available, as well as neuraminidase inhibitors. Also, drugs for the treatment of viral hepatitis and patients with HIV/AIDS have not only increased life quality and expectancy, but also decreased the incidence of some viral infections. Antiviral drugs are important tools to the clinician, especially when treating patients with impaired immunological and clinical condition. Aiming to restore health and prevent further adverse events, the clinician must be aware of the best antiviral drug available, its proper route of administration and dosage. The aim of this review is to present the antiviral drugs currently available, focusing on treatment of common viral infections in clinical practice. A brief description of the mechanisms of action and prescription of antiviral drugs is presented, using the data available from evidence-based medicine.

Oral lesions frequency in HIV-positive patients at a tertiary hospital, Southern Brazil

AIM: To report the frequency of oral lesions in HIV-positive patients on Highly Active Antiretroviral Therapy (HAART), comparing with a non-HIV infected control group, and to correlate the presence of lesions with demographic and clinical features of HIV-seropositive patients. METHODS: A quantitative case-control study was conducted by a dental professional, using a questionnaire, analysis of medical records of patients and clinical examinations. RESULTS: According to the results, oral lesions were found in 23% of HIV-positive patients versus 5% in controls. Candidiasis (29%) and periodontal changes (25%) were the most frequent oral lesions found in these patients. Gender and viral load values were statistically significant when HIV-positive patients with and without oral lesions were compared. CONCLUSIONS: The results showed a change in lesion pattern of HIV patients on HAART, highlighting a high frequency of these new lesions and reinforcing the need for periodic dental evaluation of HIV-positive patients.