Chattopadhyay Amit, Caplan Daniel J, Slade Gary D, Shugars Diane C, Tien Hsaio-Chuan, Patton Lauren L
Department of Informatics, School of Dentistry, Temple University, Philadelphia, PA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Jan;99(1):39-47. doi: 10.1016/j.tripleo.2004.06.081.
To establish incidence rates and risk factors for HIV-associated oral candidiasis (OC), oral hairy leukoplakia (OHL), and any HIV-associated oral diseases (HIV-OD).
This prospective, cumulative case-control study followed 283 initially oral disease-free HIV-1-infected men and women for 2 years. Incidence rate ratios (IRR) and incidence proportions for OC, OHL, and HIV-OD were estimated. Multivariable analyses using Poisson regression determined the most parsimonious best-fitting model explaining the outcomes.
Incidence rate (per 1000 person-months) was 9.3 for OC, 6.8 for OHL, and 13.5 for HIV-OD. Incidence of OC was associated with low CD4 count (adjusted IRR = 3.0 (95% CI = 1.7, 5.1)), smoking (IRR = 1.9 (1.0, 3.8)) and combination antiretroviral therapy (IRR = 0.3 (0.1, 0.8)). Incidence of OHL was associated with low CD4 count, conditional upon smoking status. Conclusions Low CD4 count and smoking are important risk factors for HIV-associated OC and OHL. Antiretroviral medications are protective for OC but not for OHL.
确定人类免疫缺陷病毒(HIV)相关口腔念珠菌病(OC)、口腔毛状白斑(OHL)以及任何HIV相关口腔疾病(HIV-OD)的发病率和危险因素。
这项前瞻性累积病例对照研究对283名最初无口腔疾病的HIV-1感染男性和女性进行了为期2年的随访。估计了OC、OHL和HIV-OD的发病率比(IRR)和发病比例。使用泊松回归进行多变量分析,确定了解释结果的最简约最佳拟合模型。
OC的发病率(每1000人月)为9.3,OHL为6.8,HIV-OD为13.5。OC的发病率与低CD⁴细胞计数(校正IRR = 3.0(95%CI = 1.7,5.1))、吸烟(IRR = 1.9(1.0,3.8))和联合抗逆转录病毒治疗(IRR = 0.3(0.1,0.8))相关。OHL的发病率与低CD⁴细胞计数相关,取决于吸烟状况。结论低CD⁴细胞计数和吸烟是HIV相关OC和OHL的重要危险因素。抗逆转录病毒药物对OC有保护作用,但对OHL没有。