Miziara Ivan Dieb, Weber Raimar
ENT Discipline, Sao Paulo University Medical School - Group of Otorhinolaryngology and AIDS, Sao Paulo, Brazil.
J Oral Pathol Med. 2008 Feb;37(2):99-106. doi: 10.1111/j.1600-0714.2007.00598.x.
Evaluate the accuracy of HIV-related oral lesions to predict immune and virologic failure on HIV-infected children in use of highly active antiretroviral therapy (HAART).
Data for this cross-sectional analysis come from a longitudinal study being conducted through the HIV-AIDS Outpatient Unit, ENT Division, Hospital das Clinicas, Sao Paulo University Medical School. The study began in January 1990 and is still ongoing. The cut-off point for analyses purposes was December 2004. Subjects were 471 HIV-infected consecutive children attending the outpatient unit during this period, who enrolled regardless of medical or immunological status. The children have undertaken oral cavity examination, serum CD4(+) T-lymphocyte count, and, 271 of them, viral load measurement. Sensitivity, specificity, positive predictive value, negative predictive value and relative risk were calculated.
Oral lesions had moderate sensitivity, high specificity and positive predictive value to predict immune failure. It had low sensitivity and positive predictive value, and high specificity to predict virologic failure.
Oral manifestations of HIV can be important markers for immune suppression and for virologic failure, in Brazilian children undergoing HAART.
评估与HIV相关的口腔病变对接受高效抗逆转录病毒治疗（HAART）的HIV感染儿童免疫和病毒学失败的预测准确性。
本次横断面分析的数据来自圣保罗大学医学院临床医院耳鼻喉科HIV - 艾滋病门诊正在进行的一项纵向研究。该研究始于1990年1月，目前仍在进行中。分析的截止时间为2004年12月。研究对象为在此期间连续就诊于门诊的471名HIV感染儿童，他们无论医疗或免疫状况如何均被纳入研究。这些儿童均接受了口腔检查、血清CD4(+) T淋巴细胞计数检查，其中271名儿童还进行了病毒载量检测。计算了敏感性、特异性、阳性预测值、阴性预测值和相对风险。
口腔病变在预测免疫失败方面具有中等敏感性、高特异性和阳性预测值。在预测病毒学失败方面，其敏感性和阳性预测值较低，特异性较高。
在接受HAART的巴西儿童中，HIV的口腔表现可能是免疫抑制和病毒学失败的重要标志物。
