HIV infection is associated with an increased prevalence of bone mineral density (BMD) disorders, including osteopenia and osteoporosis: 28% to 50% of seropositive individuals present BMD reduction, compared with about 16% in the general population. Oral pathologies are also common in immunosuppressed patients receiving antiretroviral therapy (ART), occurring at higher frequencies than in HIV-negative individuals.

To describe the distribution of oral pathologies among HIV-positive individuals participating in a study of bone metabolism alterations during ART use.

Analytical, cross-sectional study including 120 individuals (60 HIV-positive and 60 HIV-negative), of both sexes, aged 20–70 years. Panoramic radiographs were digitized and subjected to morphometric analyses, including linear and angular measurements, using specific software for radiographic evaluation. Data were analyzed using parametric or nonparametric tests according to distribution. Additionally, a systematic literature review was conducted to contextualize findings.

The study validated panoramic radiographic measurements of mandibular cortical thickness, particularly near the mental foramen and antegonial regions. Among PLHIV, oral pathologies were distributed as follows (number of cases/percentage within group): candidiasis (20/29.4%), none (16/23.5%), gingivitis (14/20.6%), herpes simplex (12/17.6%), periodontitis (5/7.3%), and HPV (1/1.5%).

PLHIV exhibit a higher prevalence of oral pathologies compared to HIV-negative individuals, due to immunosuppression, ART effects, and associated comorbidities. The most frequent conditions include opportunistic lesions, viral diseases, salivary alterations, caries, and neoplasms. Studies show that 60–90% of HIV-positive patients develop at least one oral manifestation during disease progression, compared to less than 20% in the general population. Regular dental follow-up is essential for early diagnosis and management of these conditions in PLHIV.