Gaitán-Cepeda Luis Alberto, Martínez-González Mario, Ceballos-Salobreña Alejandro
Clinical and Experimental Pathology Department, Postgraduate and Research Division, Dental School, National Autonomous University of Mexico, México City, México.
AIDS Patient Care STDS. 2005 Feb;19(2):70-7. doi: 10.1089/apc.2005.19.70.
Oral candidosis (OC) has been proposed as a clinical marker of highly active antiretroviral therapy (HAART) success or failure. The principal objective of this work was to assess whether the presence OC is associated with immunologic or virologic failure in patients with HIV/AIDS undergoing HAART. One hundred fifty-one patients with HIV/AIDS from Regional Hospital "Carlos Haya," Malaga, Spain, were examined orally. All patients had been undergoing HAART for a minimum of 6 months prior to oral examination. OC diagnosis was in accordance with World Health Organization-Centers for Disease Control (WHO-CDC) criteria. Age, gender, route of HIV infection, CD4 lymphocyte counts, and viral load were taken from the medical records. In regard to HAART response the patients were classified as: virologic- responders (viral load < 50 copies per milliliter), virologic nonresponders (viral load >50 copies per milliliter); immunologic responders (CD4 cells counts > 500 per milliliter), and immunologic nonresponders (CD4 cells counts < 500 per milliliter). Prevalence of OC was determined for each group. The presence of OC was closely related to immune failure (p 0.006; odds ratio [OR] 3.38 95% confidence interval [CI] 1.262-12.046) in patients with HIV/AIDS undergoing HAART. The probability of immune failure in the presence of OC was 91% for men who have sex with men, 95.5% for heterosexuals, and 96% for intravenous drug users. In conclusion, OC should be considered a clinical marker of immune failure in patients with HIV/AIDS undergoing HAART.
口腔念珠菌病（OC）已被提议作为高效抗逆转录病毒治疗（HAART）成败的临床标志物。这项研究的主要目的是评估在接受HAART的HIV/AIDS患者中，OC的存在是否与免疫或病毒学失败相关。对来自西班牙马拉加“卡洛斯·哈亚”地区医院的151例HIV/AIDS患者进行了口腔检查。所有患者在口腔检查前至少已接受HAART治疗6个月。OC的诊断符合世界卫生组织-疾病控制中心（WHO-CDC）标准。从病历中获取患者的年龄、性别、HIV感染途径、CD4淋巴细胞计数和病毒载量。关于HAART反应，患者被分类为：病毒学应答者（病毒载量<每毫升50拷贝）、病毒学无应答者（病毒载量>每毫升50拷贝）；免疫应答者（CD4细胞计数>每毫升500个）和免疫无应答者（CD4细胞计数<每毫升500个）。确定每组OC的患病率。在接受HAART的HIV/AIDS患者中，OC的存在与免疫失败密切相关（p = 0.006；优势比[OR] 3.38，95%置信区间[CI] 1.262 - 12.046）。在存在OC时，男男性行为者免疫失败的概率为91%，异性恋者为95.5%，静脉吸毒者为96%。总之，OC应被视为接受HAART的HIV/AIDS患者免疫失败的临床标志物。
