No well-designed studies of topical agents for treatment of HIV-related oral ulcers


Oral Ulcers occur more frequently, last longer and produce more painful symptoms in HIV-infected adults. Aphthous ulcers are generally classified as major, minor or herpetiform. Major ulcers can exceed 3cm in diameter and can develop into large necrotic lesions. Major ulcers are seen more commonly in HIV-infected than non-infected adults.  The aim of this Cochrane review was to evaluate the efficacy and side effects of topical agents used in the treatment of HIV-related oral aphthous ulcers in adults.

What did they do

The Embase, PubMed and Cochrane Central Registry of Controlled trials( CENTRAL) was searched together with relevant conference proceedings with no language restrictions. Only randomised controlled trials  evaluating any topical treatment for HIV oral aphthous ulceration were considered.

What did they find

A total of 233 abstracts were retrieved from the databases searched. None of the identified studies met our inclusion criteria. Ten of the studies identified were reports of systemic rather than topical treatment. Therefore, no studies were included in this review.

The authors concluded

There is a need for well designed studies to evaluate the efficacy and safety of topical agents for the treatment of HIV related oral aphthous ulcers.


HIV/AIDS is the 6th leading cause of death worldwide and the leading cause of death in Africa. It is estimated that around 4 million people are newly infected each year. Data from UK  surveillance reports at the end of December 2011 indicate that 5,600 people (4,050 men and 1,550 women) were diagnosed with HIV in the United Kingdom in 2011 (Health Protection Report).


Kuteyi T, Okwundu CI. Topical treatments for HIV-related oral ulcers. Cochrane Database of Systematic Reviews 2012, Issue 1. Art. No.: CD007975. DOI: 10.1002/14651858.CD007975.pub2.

Health Protection Report April 2012


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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