HIV Mouth Sores: Causes, Symptoms and Treatments

woman have hiv sore on mouth at lip
Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  • Mouth sores are a common symptom in individuals with HIV due to weakened immunity, and they can be caused by various infectious agents such as candidiasis, herpes simplex virus (HSV), and sexually transmitted infections.
  • These sores can be painful, appear on the lips or inside the mouth, and may last longer and be more severe compared to those experienced by individuals with a healthy immune system.
  • Treatment for HIV mouth sores involves addressing the underlying cause, such as antifungal or antiviral medications, and managing symptoms to alleviate discomfort. It is important to consult a healthcare professional for proper diagnosis and treatment.

Overview

Mouth sores are common symptom that occur in HIV-positive people. It is due to the infection which decreases your immunity to fight against the human immunodeficiency virus (HIV).  These sores often appear either on the lips or on the region around the mouth. This causes pain while eating or speaking and impacts the quality of life. Mouth sores are not experienced by everyone who has HIV. However, it can occur in patients with progressive infection and weak immunity. The people who suffer from mouth sores during HIV infection are around 50%, while those with the AIDS stage are 80%. This blog explores the causes, treatment, signs of HIV mouth sores, and when to consult a doctor.

What are HIV Mouth Sores?

If a person is suffering from HIV infection, it can give entry to numerous infection-causing microbes which are otherwise deleted by our immune system. That’s why viruses causing oral sores, like herpes simplex virus have a higher chance of infecting a HIV-positive person than a healthy person. These sores appear as red blisters around the mouth, which are painful and also called cold sores. These are also called as fever blisters when they appear on the lips. These sores, when develop during HIV infection, can last a bit longer than the ones that develop during a healthy immune state and are more severe.

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Causes of HIV Mouth Sores

During an HIV infection, the development of sores can take place in many different forms and can be the result of various infectious agents as the body is exposed to different pathogens during that immunocompromised state. 

Sores- Inside the Mouth

When developed inside the mouth, following the causal agents: 

Oral Thrush

It is caused by a fungus, candida which causes candidiasis. This fungus causes beige color sores in the mouth which accompany bleeding. Oral thrush occurs during advanced HIV condition as the fungus is opportunistic and only cause infection when the immunity is compromised. 

However, for oral thrush treatment, there are some effective antifungal medicines like lozenge or using antifungal mouthwash for mild infection. However, you might need a prescription for anti-treatment options for severe infections. 

Canker Sores

These sores are more like ulcers as their other name, aphthous ulcers, suggest. These ulcers develop inside the mouth on the inner surface of the lips and cheeks, on the base of gums, or below the tongue. Although this infection is not contagious, but the ulcers are quite painful and HIV-positive patients have a higher chance of developing this infection as compared to those who don’t have HIV infection. For the treatment of these sores, doctors recommend antiseptic mouthwash if the infection is mild. 

Oral Hairy Leukoplakia

In this infection, hair-like growths develop on the tongue with white patches and ridges. However, they are not limited to the mouth and can also develop anywhere else in the body. The causal agent of this infection is Epstein-Barr virus. This virus attacks when the immune system is compromised and during the advanced HIV stage. Mild cases don’t always require treatment but if the condition is severe you might need to see a doctor immediately for the prescription of a suitable medication course. 

Sexually Transmitted Infections

During HIV infection, due to weekend immunity there is a higher chance of developing sexually transmitted infections which causes sores inside the mouth as follows: 

  • Syphilis: It is a sexual transmission infection in which sores develop inside the mouth on the tongue, lips, back of mouth or in gums. Specific antibiotics can cure this disease. Talk to your provider for the proper diagnosis and treatment. 
  • Gonorrhea: It is another STI that causes the appearance of white spots in the mouth or in the throat. Your doctor will recommend antibiotics for the treatment of gonorrhea mouth sores. Gonorrhea, which could cause a sore throat and sometimes white spots in your mouth. Antibiotics are the usual treatment.
  • Human Papilloma Virus (HPV) warts: In case of HPV infection, painless warts or lesions inside the mouth develops which are surgically removed

Sores – On or Over the Mouth

Then comes the sores that develop on or around the mouth area such as:

Herpes Simplex Virus (HSV) Sores 

These sores develop in case of herpes infection and appear on or around the mouth especially if you are suffering from HIV. It also acts as an opportunistic pathogen that wakes up when immunity is compromised and stays in the body long before the infection occurs. There are two types of this virus each causing different conditions as 

  • HSV1 causes sores on or near the mouth
  • HSV2 causes sores on the genitals or near the genital area

Following are the signs and symptoms of oral herpes you should look for: 

  • It is contagious especially before and during an outbreak
  • It these sores are persistent from a long time it can indicate AIDS early signs
  • Viruses like HSV are treatment resistant and can cause worst symptoms
  • These sores vary from clear, red, pink, to even gray or yellow
  • Some antiviral prescription medicines can help them heal faster
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What are the signs of HIV on the mouth?

HIV sores on the mouth can take many different forms from oral thrush, dry mouth, oral ulcers, warts, gingivitis (gum disease), and cold sores caused by herpes simplex virus. In any of the case, the sores are painful, raised blisters, that either develop over the lips or around mouth or occur inside the mouth like on gums, back of throat, tongue or in the soft palate. Following are the other symptoms that a person may experience along side: 

  • Muscle Aches
  • Fever
  • Swollen Lymph nodes
  • Fatigue
  • Burning sensation near or in the sores

Out of all the causes, oral herpes is highly contagious and can spread via the saliva of infected person therefore avoid sharing food, kissing, or sharing personal care items. 

Treatment for HIV Mouth Sores

HIV related mouth sores can be treated depending upon the cause. If the cause is bacterial, viral or fungal infection, the suitable antibacterial, antiviral, or antifungal prescription medication can heal the sores. Some antiviral medications like acyclovir or valacyclovir can help treat the HSV infection faster. Talk to your doctor for the prescription of suitable medicine. Some mild infections like canker sores can be treated using the prescription mouthwash which contains corticosteroids.

However, the long-standing sores like HPV warts may require surgery for complete removal like cryotherapy in which warts are freezed before removing. Other serious conditions like oral cancer require more rigorous treatments like chemotherapy, surgery, or radiation therapy.

Can Mouth Sores be Prevented?

You can prevent mouth sores by regular checkups, and managing any existing mouth conditions. Moreover, perform following hygiene practices to prevent mouth sores: 

  • Drink plenty of water to fulfil hydration levels
  • Eat a balanced diet
  • Quit smoking
  • Take HIV medications consistently
  • Avoid spicy or too acidic foods and beverages
  • Practice oral hygiene

Consult a Doctor

If you develop painful sores that last more than a week or two and cause difficulty while swallowing medicine or food, consult your provider immediately.

FAQs About HIV Mouth Sores

At what stage does HIV cause mouth sores?

Mouth sores are more common to occur during advanced stage of infection like during AIDS stage. It occurs due to weakened immunity as a result of HIV infection causing acquired immunodeficiency syndrome (AIDS).

Do mouth sores mean you have HIV?

It is not always the case but there is a higher chance of mouth sores in HIV positive patients as compared to those without HIV infection.

How common is mouth sores in HIV?

Mouth sores during HIV infection is common in 50% of HIV positive patients and chances are as high as 80% in those who are at advanced HIV stage i.e., AIDS.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

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