Jensen Tomas O, Tam Vu V, Mai Nguyen T, Ut Do Q, Dat Doan D, Lien Nguyen T, Nga Nguyen T, Bygbjerg Ib C
Department of International Health, Institute of Public Health, University of Copenhagen, Denmark.
Southeast Asian J Trop Med Public Health. 2005 Nov;36(6):1459-68.
This study reports clinical features, with emphasis on oral lesions and constitutional signs, of 170 patients in a regional hospital in northern Vietnam, of whom 56 were HIV positive. The purpose of the study was to investigate the relationship of oral hairy leukoplakia (OHL) and oropharyngeal candidiasis (OPC) with HIV infection and late stage HIV disease. Late stage HIV disease was defined as WHO stage III or IV and/or a total lymphocyte count below 1200 cells/mm3. The 56 HIV positive patients included all patients with a positive HIV test between July 7th and September 9th 2002. A total of 114 HIV negative controls were included as well. All patients had a detailed medical history and examination as well as a thorough oral examination, which were all done without prior knowledge of the patient's HIV serostatus. HIV positive patients were then grouped according to WHO clinical stage and total lymphocyte count. Thirty-six patients (64.3%) out of 56 HIV positives were in WHO stage III+IV and 28 patients (50.0%) had a total lymphocyte count below 1200 cells/mm3. The presence of OPC, weight loss of more than 10% of body weight and/or chronic fever of more than one month's duration showed a significant association and high positive prediction with HIV infection, especially late stage HIV disease [all with odds ratio (OR) and 95% confidence interval (CI > 1)]. The presence of OHL only showed a significant association with positive HIV serostatus and WHO stage III+IV. It can be concluded that in North Vietnam, HIV positive patients and patients suspected of having HIV infection would benefit from initial and repeat oral examinations. OPC, together with other signs of progressive infection (constitutional signs, such as weight loss and chronic fever) may serve as indicators for institution of prophylactic drugs against opportunistic infections and even antiretroviral (ARV) therapy, when available. However, further research is needed to demonstrate the role of OHL in HIV patients in North Vietnam.
本研究报告了越南北方一家地区医院170例患者的临床特征，重点关注口腔病变和全身症状，其中56例为HIV阳性。本研究的目的是调查口腔毛状白斑（OHL）和口咽念珠菌病（OPC）与HIV感染及晚期HIV疾病之间的关系。晚期HIV疾病定义为世界卫生组织（WHO）III期或IV期和/或总淋巴细胞计数低于1200个细胞/mm³。56例HIV阳性患者包括2002年7月7日至9月9日期间所有HIV检测呈阳性的患者。此外还纳入了114例HIV阴性对照。所有患者均有详细的病史和检查，以及全面的口腔检查，所有这些检查均在不了解患者HIV血清学状态的情况下进行。然后根据WHO临床分期和总淋巴细胞计数对HIV阳性患者进行分组。56例HIV阳性患者中，36例（64.3%）处于WHO III + IV期，28例（50.0%）总淋巴细胞计数低于1200个细胞/mm³。OPC的存在、体重减轻超过体重的10%和/或持续一个多月的慢性发热与HIV感染，尤其是晚期HIV疾病显示出显著关联和高阳性预测价值[所有比值比（OR）和95%置信区间（CI）>1]。仅OHL的存在与HIV血清学阳性和WHO III + IV期显示出显著关联。可以得出结论，在越南北部，HIV阳性患者和疑似感染HIV的患者将从初次和重复口腔检查中受益。OPC与其他进展性感染迹象（全身症状，如体重减轻和慢性发热）一起，可作为开始使用抗机会性感染预防性药物甚至抗逆转录病毒（ARV）治疗（如可用）的指标。然而，需要进一步研究以证明OHL在越南北部HIV患者中的作用。
