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Oral clinical and cytological assessment of patients on HIV pre-exposure prophylaxis: a prospective study in Curitiba, Brazil

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Dec 9:S2212-4403(25)01349-5. doi: 10.1016/j.oooo.2025.11.016. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate oral clinical and cytological changes in patients on HIV pre-exposure prophylaxis (PrEP).

STUDY DESIGN: Clinical evaluations and epithelial cell smears were done on ventral tongue, buccal, and labial mucosa before treatment (T0), after 30 (T30), and 120 days (T120) of PrEP use. Clinical changes were assessed using questionnaires and oral examinations, and a descriptive analysis was performed. Cellular changes were observed through liquid-based exfoliative cytology, and the Wilcoxon and McNemar tests were applied.

RESULTS: Sixty-three patients (60 males, 3 females; mean age 29.65) were included; 36 returned at T30 and 20 at T120. Most frequent complaints were dry mouth and increased fluid intake. Wilcoxon test showed no systematic observer error (P > .05). Karyomegaly increased significantly in all sites at T30 and in ventral tongue and buccal mucosa at T30 and T120 (P < .05). Keratinization increased significantly in buccal mucosa at T30 and ventral tongue at T30 and T120 (P < .05).

CONCLUSION: Our findings indicate an increase in oral epithelial changes during the first 30 and 120 days of PrEP use. Although these changes are nonspecific, continuous oral health monitoring may support early detection of alterations and adherence among patients on HIV PrEP.

PMID:41484006 | DOI:10.1016/j.oooo.2025.11.016

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