坦桑尼亚感染艾滋病毒的成年人口腔病变与临床和免疫状况的关系

Occurrence of oral lesions in relation to clinical and immunological status among HIV-infected adult Tanzanians.

作者信息

Matee M I, Scheutz F, Moshy J

机构信息

Department of Microbiology and Immunology, Muhimbili University College of Health Sciences, PO Box 65001, Dar es Salaam, Tanzania.

出版信息

Oral Dis. 2000 Mar;6(2):106-11. doi: 10.1111/j.1601-0825.2000.tb00110.x.

DOI:10.1111/j.1601-0825.2000.tb00110.x

PMID:10702788

Abstract

OBJECTIVE

To determine the association, if any, between the presence of oral lesions and clinical and immunological status of untreated HIV-infected adults in Tanzania.

DESIGN

A cross-sectional study.

SETTING

AIDS Clinical Trial Clinic (ATCC) at Muhimbili Medical Centre in Dar-es-Salaam, Tanzania.

SUBJECTS

192 HIV-infected individuals not receiving treatment; 156 individuals confirmed to be HIV-seronegative acted as a control group.

METHODS

Examination of oral structures, determination of HIV serostatus, clinical status, and peripheral CD4+ T cell and total lymphocyte counts.

MAIN OUTCOME MEASURE

Presence of oral lesions.

RESULTS

Intra-oral lesions were seen among 7.7% of the HIV-seronegative, 10.4% of the HIV-seropositive and 36.8% of the AIDS groups, respectively. Enlarged parotid glands were seen in 20% of the AIDS patients, 11.9% of the HIV-seropositives, and 5.1% of the HIV seronegatives. Enlargement of submandibular salivary glands was seen in 29.6% of the AIDS patients, 31.3% of the HIV-seropositives compared with 14.7% among the HIV-seronegatives. Multiple regression analysis was used to calculate adjusted odds ratio (OR) for presence of oral lesions. OR for an intra-oral lesion was 1.6 (95% CI = 0.5; 5.0) among the HIV-seropositives and 8.2 (95% CI = 3.5; 19.7) among the AIDS patients using the HIV-seronegatives as reference. OR for an intra-oral lesion was 0.9 (95% CI = 0.3; 2.9) in HIV-infected patients with peripheral CD4+ T cell count of between 200-500 cells mm-3 and 2.7 (95% CI = 0.9; 7.7) in patients with less than 200 cells mm-3. OR for an intra-oral lesion was 0.4 (95% CI = 0.2; 0.9) for patients with peripheral total lymphocyte counts of between 1000-2000 cells mm-3 and 0.9 (95 CI = 0.4; 2.0) for patients with less than 1000 cells mm-3.

CONCLUSION

The association of oral lesions with the clinical stage of HIV infection and to a lesser extent peripheral CD4+ T cell count does suggest that these lesions could be used as additional markers of immunosuppression and AIDS.

摘要

目的

确定坦桑尼亚未接受治疗的HIV感染成人的口腔病变与临床及免疫状态之间是否存在关联（若存在关联）。

设计

横断面研究。

地点

坦桑尼亚达累斯萨拉姆市穆希姆比利医疗中心的艾滋病临床试验诊所（ATCC）。

研究对象

192名未接受治疗的HIV感染者；156名经确认HIV血清学阴性的个体作为对照组。

方法

检查口腔结构，确定HIV血清学状态、临床状态以及外周血CD4+ T细胞和总淋巴细胞计数。

主要观察指标

口腔病变的存在情况。

结果

HIV血清学阴性者中7.7%、HIV血清学阳性者中10.4%以及艾滋病患者中36.8%出现口腔内病变。20%的艾滋病患者、11.9%的HIV血清学阳性者以及5.1%的HIV血清学阴性者出现腮腺肿大。29.6%的艾滋病患者、31.3%的HIV血清学阳性者出现颌下唾液腺肿大，而HIV血清学阴性者中这一比例为14.7%。采用多元回归分析计算口腔病变存在情况的调整比值比（OR）。以HIV血清学阴性者为参照，HIV血清学阳性者口腔内病变的OR为1.6（95%置信区间 = 0.5；5.0），艾滋病患者为8.2（95%置信区间 = 3.5；19.7）。外周血CD4+ T细胞计数在200 - 500个/mm³之间的HIV感染患者口腔内病变的OR为0.9（95%置信区间 = 0.3；2.9），低于200个/mm³的患者为2.7（95%置信区间 = 0.9；7.7）。外周血总淋巴细胞计数在1000 - 2000个/mm³之间的患者口腔内病变的OR为0.4（95%置信区间 = 0.2；0.9），低于1000个/mm³的患者为0.9（95%置信区间 = 0.4；2.0）。