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David J. Acer (November 11, 1949 – September 3, 1990) was an American dentist who allegedly infected six of his patients, including Kimberly Bergalis, with HIV. [1] The Acer case is considered the first documented HIV transmission from a healthcare worker to a patient in the United States, [2] though the means of transmission remain unknown. [3]
Kimberly Ann Bergalis (January 19, 1968 – December 8, 1991) was an American woman who was one of six patients purportedly infected with HIV by dentist David J. Acer, who was infected with HIV and died of AIDS on September 3, 1990.
Linear gingival erythema (LGE) is a periodontal disorder diagnosed based on distinct clinical characteristics. It was originally thought that LGE was directly associated with HIV, and it was thus called HIV-associated gingivitis (HIV-G).
Non-plaque-induced gingival disease is an inflammation of the gingiva that does not result from dental plaque, but from other gingival diseases caused by bacterial, viral, fungal, or genetic sources. Although this gingival disease is less common than those which are plaque-induced, it can have a serious impact on the patient's overall health.
HIV is a retrovirus that primarily infects components of the human immune system such as CD4 + T cells, macrophages and dendritic cells. It directly and indirectly destroys CD4 + T cells. [88] HIV is a member of the genus Lentivirus, [89] part of the family Retroviridae. [90] Lentiviruses share many morphological and biological characteristics.
HIV-SGD is more prevalent in HIV positive children than HIV positive adults, [4] at about 19% and 1% respectively. [1] Unlike other oral manifestations of HIV/AIDS such as Kaposi sarcoma, oral hairy leukoplakia and oral candidiasis, which decreased following the introduction of highly active antiretroviral therapy (HAART), HIV-SGD has increased.
The key to any diagnosis is thorough medical, dental, social and psychological history as well as assessing certain lifestyle risk factors that may be involved in disease processes. This is followed by a thorough clinical investigation including extra-oral and intra-oral hard and soft tissues.
The International Myeloma Foundation's web-based survey included 1203 respondents, 904 patients with myeloma and 299 with breast cancer and an estimate that after 36 months, osteonecrosis of the jaw had been diagnosed in 10% of 211 patients on zoledronate and 4% of 413 on pamidronate. [16]