Expósito-Delgado Antonio Javier, Vallejo-Bolaños Encarnación, Martos-Cobo Eva Gloria
Universidad de Granada.
Med Oral Patol Oral Cir Bucal. 2004 Nov-Dec;9(5):415-20; 410-5.
The vast majority of children with HIV infection present oral manifestations among the first signs of illness. These lesions are not produced directly by the virus, but are manifestations associated with HIV infection, and are not pathognomic of the infection itself. Some of these oral lesions have a prognostic value with regard to progression of the infection and the appearance of AIDS; independently of other, more commonly used markers. The essential risk factors that influence the development of such oral manifestations are the low number of CD4+ lymphocytes, xerostomia, and the lack of anti-retroviral therapy. Opportunist infections, such as mycoses -- including pseudomembranous oral candidiasis, are found with higher frequency; followed by the herpetic viral infections. The oral lesions that appear in infected children differ in prevalence from those found in seropositive adults, some, such as parotid hypertrophy, present more exclusively in children, others, such as periodontal bacterial infections and Kaposi's Sarcoma, are lesions that predominate in the adult HIV-infected population. Given the current impact of the pandemic caused by HIV, it is the responsibility of dental professionals to prevent, detect, treat and control the oral lesions in those patients infected with HIV. All of which will be reflected in a reduction in transmission, lower mortality and greater long-term survival for infected children.
绝大多数感染艾滋病毒的儿童在发病初期就会出现口腔症状。这些病变并非由病毒直接引起,而是与艾滋病毒感染相关的表现,并非该感染本身所特有的。其中一些口腔病变对于感染的进展和艾滋病的出现具有预后价值;独立于其他更常用的指标。影响此类口腔表现发展的主要危险因素是CD4 +淋巴细胞数量低、口干症以及缺乏抗逆转录病毒治疗。机会性感染,如真菌病——包括假膜性口腔念珠菌病,出现频率更高;其次是疱疹病毒感染。受感染儿童出现的口腔病变在患病率上与血清反应阳性的成年人不同,一些病变,如腮腺肥大,更常见于儿童,而其他病变,如牙周细菌感染和卡波西肉瘤,则是在成年艾滋病毒感染人群中占主导的病变。鉴于目前艾滋病毒大流行的影响,牙科专业人员有责任预防、检测、治疗和控制艾滋病毒感染患者的口腔病变。所有这些都将体现在减少传播、降低死亡率以及提高受感染儿童的长期生存率上。