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Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, South Africa ACRONYMS aMSH: alpha melanocyte stimulating hormone HAART: highly active antiretroviral therapy MC1R: melanocortin 1 receptor OMH: Oral melanin hyperpigmentation HIV-OMH: HIV associated oral melanin hyperpigmentation INTRODUCTION Oral melanin hyperpigmentation (OMH) is not uncommon in HIV+ persons 1 In Venezuela (38%) 5 and in India (30%) 3 HIV-associated OMH (HIV-OMH) is quite common, but by contrast is substantially less common in Italy (6.4%) 4 and in sub-Saharan Africa (Tanzania, 4.7%, Kenya, 6%)

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For instance, ossicle formation in Achilles tendon tissue appears with osteogenic protein 1 (OP-1) (Forslund and Aspenberg, 1998)