Ramírez-Amador Velia, Anaya-Saavedra Gabriela, Calva Juan J, Clemades-Pérez-de-Corcho Tirso, López-Martínez Carlos, González-Ramírez Imelda, Sierra-Madero Juan
Universidad Autónoma Metropolitana-Xochimilco, México D.F., México.
Arch Med Res. 2006 Jul;37(5):646-54. doi: 10.1016/j.arcmed.2006.01.002.
The aim of the present study was to compare the prevalence of HIV-related oral lesions (HIV-OL) between two health centers for HIV in Mexico City and to analyze the factors that, in addition to combined antiretroviral therapy (CART) and low CD4(+), may be associated with possible differences in prevalence.
A cross-sectional observational study was performed between January 2000 and February 2003 at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a specialized referral center for HIV/AIDS patients and the Clínica Especializada Condesa (CEC), a primary care center for HIV-infected individuals without social security insurance. A consecutive sample of HIV-infected individuals had an oral examination based on established clinical criteria. Demographic, clinical and laboratory data were obtained. Independent association of each factor with specific HIV-OL was assessed by logistic regression modeling.
Eight hundred fifty individuals were examined (INCMNSZ: 479; CEC: 371). Hairy leukoplakia (HL), periodontal disease (PD) and Kaposi's sarcoma (KS) were independently associated with the study site [odds ratio (OR) = 1.7 (95% confidence interval (CI): 1.1-2.4), OR = 4.2 (95% CI: 1.3-13), OR = 10.1 (95% CI: 2.7-38.2), respectively], being more frequent in CEC patients. HL was independently associated with men having sex with men OR = 1.7 (95% CI: 1.1-2.8). All HIV-OL were independently associated with CD4(+) counts and, with the exception of PD and KS, with time under CART.
The present comparative study showed that several factors were associated with a difference in prevalence of oral lesions found in two AIDS clinics located in Mexico City. Severe immune suppression, CART duration and the study site were associated with HIV-OL. Further investigation into factors such as socioeconomic determinants associated with HIV-OL is warranted.
本研究旨在比较墨西哥城两个艾滋病健康中心与HIV相关口腔病变（HIV-OL）的患病率，并分析除联合抗逆转录病毒疗法（CART）和低CD4(+)之外，可能与患病率差异相关的因素。
2000年1月至2003年2月间，在国立医学与营养科学研究所萨尔瓦多·苏比拉án（INCMNSZ）（一家针对HIV/AIDS患者的专业转诊中心）和孔德萨专科诊所（CEC）（一家为无社会保险的HIV感染者提供初级护理的中心）进行了一项横断面观察性研究。对连续抽取的HIV感染者样本，依据既定临床标准进行口腔检查。获取了人口统计学、临床和实验室数据。通过逻辑回归模型评估各因素与特定HIV-OL的独立关联性。
共检查了850人（INCMNSZ：479人；CEC：371人）。毛状白斑（HL）、牙周病（PD）和卡波西肉瘤（KS）与研究地点独立相关[比值比（OR）分别为1.7（95%置信区间（CI）：1.1 - 2.4）、OR = 4.2（95% CI：1.3 - 13）、OR = 10.1（95% CI：2.7 - 38.2）]，在CEC患者中更为常见。HL与男男性行为独立相关，OR = 1.7（95% CI：1.1 - 2.8）。所有HIV-OL均与CD4(+)计数独立相关，除PD和KS外，还与接受CART的时间相关。
本比较研究表明，若干因素与墨西哥城两家艾滋病诊所发现的口腔病变患病率差异相关。严重免疫抑制、CART持续时间和研究地点与HIV-OL相关。有必要进一步调查与HIV-OL相关的社会经济决定因素等因素。
