Ramírez-Amador V A, Espinosa E, González-Ramírez I, Anaya-Saavedra G, Ormsby C E, Reyes-Terán G
Health Care Department, Universidad Autónoma Metropolitana-Xochimilco, Mexico City.
Int J STD AIDS. 2009 Apr;20(4):259-61. doi: 10.1258/ijsa.2008.008351.
Oral lesions such as candidosis, hairy leukoplakia (HL) and oral ulcers are strikingly absent in the numerous reports of immune reconstitution inflammatory syndrome (IRIS). To document oral manifestations attributable to immune reconstitution, we conducted a longitudinal follow-up of a cohort of HIV+ individuals starting highly active antiretroviral therapy (HAART) and completing oral pathology follow-up up to 12 weeks after treatment initiation. HIV-infected patients had oral examinations, CD4+ T-cell count and viral load determinations performed at baseline, and at weeks 4, 8 and 12 after HAART initiation. Among individuals with satisfactory viral response and recovery of > or =50 CD4+ T-cell/microL, eight patients complied with strict IRIS criteria: two developed clinical signs of oral candidosis (OC), two oral ulcers, three HL and one Kaposi's sarcoma. CD4+ T-cell counts at symptom onset suggested no remaining immune suppression. Our findings show that cases of OC, HL and recurrent ulcers can be instances of IRIS.
在众多关于免疫重建炎症综合征（IRIS）的报告中，口腔病变如念珠菌病、毛状白斑（HL）和口腔溃疡明显未被提及。为记录免疫重建所致的口腔表现，我们对一组开始高效抗逆转录病毒治疗（HAART）并在治疗开始后长达12周完成口腔病理学随访的HIV阳性个体进行了纵向随访。HIV感染患者在基线时以及HAART开始后的第4、8和12周进行了口腔检查、CD4 + T细胞计数和病毒载量测定。在病毒反应良好且CD4 + T细胞恢复至≥50个/微升的个体中，有8例符合严格的IRIS标准：2例出现口腔念珠菌病（OC）的临床体征，2例出现口腔溃疡，3例出现HL，1例出现卡波西肉瘤。症状出现时的CD4 + T细胞计数表明不存在残留的免疫抑制。我们的研究结果表明，OC、HL和复发性溃疡病例可能是IRIS的实例。
