Nicolatou-Galitis O, Velegraki A, Paikos S, Economopoulou P, Stefaniotis T, Papanikolaou I S, Kordossis T
Department of Oral Pathology and Oral Medicine, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Oral Dis. 2004 May;10(3):145-50. doi: 10.1046/j.1601-0825.2003.00994.x.
To investigate the association between the prevalence of oral lesions and highly active antiretroviral therapy (HAART) including a protease inhibitor (PI).
Prospective study.
Ninety-five consecutive patients, attending an AIDS Unit, in Greece entered the study. Fourty-four patients were receiving PI- HAART, 14 patients were on double antiretroviral therapy, and 37 patients were not receiving antiretroviral therapy at the time of oral examination. Oral lesions were diagnosed by established presumptive clinical criteria.
Oral lesions were scored. CD4 counts and viral load were determined and related to the prevalence of oral lesions.
Oral lesions, and specifically oral candidiasis, were significantly reduced (P < 0.001) in patients receiving PI-HAART. Oral lesions were significantly increased in patients with CD4 counts <200 cells microl(-1) and viral load >20,000 copies ml(-1) (P < 0.001). The percentage of patients, with lesions on PI-HAART, and with CD4 < 200 and viral load >20,000 was 1.5 times lower (37.5%vs 58.8%, P < 0.001) than that of patients not receiving antiretroviral therapy, but with similar immune and viremic status.
Oral lesions were significantly reduced in patients on PI-HAART. A direct anticandidal effect of PI was suggestive and seemed to have accounted, beyond the HAART-related immune reconstitution, for the reduction of candidiasis and all other oral lesions.
研究包括蛋白酶抑制剂（PI）在内的高效抗逆转录病毒疗法（HAART）与口腔病损患病率之间的关联。
前瞻性研究。
希腊一家艾滋病治疗中心的95例连续就诊患者纳入本研究。44例患者接受含PI的HAART治疗，14例患者接受双重抗逆转录病毒治疗，37例患者在口腔检查时未接受抗逆转录病毒治疗。根据既定的临床初步标准诊断口腔病损。
对口腔病损进行评分。测定CD4细胞计数和病毒载量，并分析其与口腔病损患病率的关系。
接受含PI的HAART治疗的患者口腔病损，尤其是口腔念珠菌病显著减少（P<0.001）。CD4细胞计数<200个/微升且病毒载量>20,000拷贝/毫升的患者口腔病损显著增加（P<0.001）。接受含PI的HAART治疗、CD4<200且病毒载量>20,000的患者病损发生率比未接受抗逆转录病毒治疗但免疫和病毒血症状态相似的患者低1.5倍（37.5%对58.8%，P<0.001）。
接受含PI的HAART治疗的患者口腔病损显著减少。PI对念珠菌有直接抗菌作用，这一作用具有提示意义，且似乎除了与HAART相关的免疫重建外，还促成了念珠菌病和所有其他口腔病损的减少。
