Moura Mariela Dutra Gontijo, Grossmann Soraya de Mattos Camargo, Fonseca Linaena Méricy da Silva, Senna Maria Inês Barreiros, Mesquita Ricardo Alves
Oral Pathology, Medicine and Surgery Department, Dentistry School, Federal University of Minas Gerais, Av. Antônio Carlos 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
J Oral Pathol Med. 2006 Jul;35(6):321-6. doi: 10.1111/j.1600-0714.2006.00428.x.
Oral hairy leukoplakia (OHL) may be an indicator of the progression of Human Immunodeficiency Virus (HIV)-induced immuno-depression, and the evaluation of risk factors leading to OHL is important in the management of these HIV-infected patients. However, there are few studies that analyze risk factors leading to OHL in the Brazilian population. The aim of this case-control study is to present data about prevalence rates and risk factors leading to OHL in a sample of HIV-infected adults in Brazil.
This case-control study included 111 HIV-infected patients treated at a clinic for sexually transmitted diseases and HIV. In the initial examinations with dentists, variables were collected from all patients. Diagnosis of OHL was performed in accordance with the International Classification System and cytological features. The Fisher and the chi-squared tests were used for statistical analysis. The proportional prevalence and odds ratio were estimated.
Outcome presented a positive, statistically significant association among the presence of OHL and viral load of 3000 copies/mul or greater (P = 0.0001; odds ratio (OR) = 5.8), presence of oral candidiasis (P = 0.0000; OR = 11.1), previous use of fluconazole (P = 0.0000; OR = 24.6), and use of systemic acyclovir (P = 0.032; OR = 4.3). Antiretroviral medication presented a negative, statistically significant association with the presence of OHL (P = 0.002; OR = 8.4).
Prevalence of OHL was 28.8%. Viral load, oral candidiasis, previous use of fluconazole, and systemic acyclovir were determined to be risk factors for OHL. Antiretroviral medication proved to be protective against the development of OHL.
口腔毛状白斑（OHL）可能是人类免疫缺陷病毒（HIV）所致免疫抑制进展的一个指标，在这些HIV感染患者的管理中，评估导致OHL的危险因素很重要。然而，在巴西人群中分析导致OHL的危险因素的研究很少。本病例对照研究的目的是呈现巴西HIV感染成年人样本中OHL的患病率及导致OHL的危险因素的数据。
本病例对照研究纳入了111名在性传播疾病和HIV诊所接受治疗的HIV感染患者。在与牙医的初次检查中，收集了所有患者的变量。OHL的诊断根据国际分类系统和细胞学特征进行。采用Fisher检验和卡方检验进行统计分析。估计了比例患病率和比值比。
结果显示，OHL的存在与病毒载量3000拷贝/微升或更高（P = 0.0001；比值比（OR）= 5.8）、口腔念珠菌病的存在（P = 0.0000；OR = 11.1）、既往使用氟康唑（P = 0.0000；OR = 24.6）以及使用全身性阿昔洛韦（P = 0.032；OR = 4.3）之间存在统计学上显著的正相关。抗逆转录病毒药物与OHL的存在呈统计学上显著的负相关（P = 0.002；OR = 8.4）。
OHL的患病率为28.8%。病毒载量、口腔念珠菌病、既往使用氟康唑和全身性阿昔洛韦被确定为OHL的危险因素。抗逆转录病毒药物被证明对OHL的发生有保护作用。
