Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro, Brazil.
J Oral Pathol Med. 2010 Feb;39(2):188-94. doi: 10.1111/j.1600-0714.2009.00857.x. Epub 2009 Dec 22.
To evaluate predisposing factors such as orofacial manifestations, immunosuppression status and antiretroviral therapy in relation to oral colonization by Candida spp. in Brazilian HIV-infected children and their uninfected siblings in the era of highly active antiretroviral therapy (HAART).
Whole stimulated saliva was collected from 65 HIV-infected children (HIV+) and 40 uninfected siblings (HIV-), followed by assessment of orofacial manifestation, caries indexes and the number of cavitated dentinal carious teeth (CDT). The salivary samples were cultured and the colonies were counted. After which they were identified by sugar assimilation and fermentation (API 20C). Data was analyzed using chi-square, Mann-Whitney, Spearman tests and logistic regression.
Regarding positive growth, HIV+ presented 80% (52/65) and HIV- 57.5% (23/40) (P = 0.013). Absence of antiretroviral therapy and HAART increased the probability of Candida isolation (P < 0.05). Mean CD4%, immune-status and history of recurrent oral candidiasis (OC) had no influence on Candida isolation. Mixed Candida spp. cultures were observed in HIV+ (40%) and HIV- (52%): C. albicans was more frequently found in both groups, with a higher prevalence in HIV+ (P = 0.05); other non-albicans species were isolated in HIV+ and HIV-. Low prevalence of orofacial manifestations was observed in HIV+ (10.7% of OC). There was an association between means of CDT and Candida growth (P < 0.05) and a positive correlation between number of CDT and Candida cfu-counts in HIV+ and HIV-. Mean CD4% and immune-status had no influence on Candida isolation. Absence of antiretroviral therapy and HAART increased the probability of Candida isolation (P < 0.05).
The HIV infected children had a significantly higher prevalence of oral Candida spp. compared to their uninfected siblings. Absence of HAART and presence of dentinal carious teeth increased significantly Candida spp. colonization in these children.
评估口腔表现、免疫抑制状态和抗逆转录病毒治疗等易患因素与巴西 HIV 感染儿童及其未感染兄弟姐妹在高效抗逆转录病毒治疗（HAART）时代口腔定植念珠菌的关系。
采集 65 名 HIV 感染儿童（HIV+）和 40 名未感染兄弟姐妹（HIV-）的全唾液刺激物，然后评估口腔表现、龋齿指数和有腔洞牙本质龋坏牙（CDT）的数量。对唾液样本进行培养并计数菌落，然后通过糖同化和发酵（API 20C）进行鉴定。采用卡方检验、Mann-Whitney 检验、Spearman 检验和逻辑回归进行数据分析。
在阳性生长方面，HIV+为 80%（52/65），HIV-为 57.5%（23/40）（P=0.013）。未接受抗逆转录病毒治疗和 HAART 增加了念珠菌分离的可能性（P<0.05）。CD4%平均值、免疫状态和复发性口腔念珠菌病（OC）病史对念珠菌分离没有影响。在 HIV+和 HIV-中观察到混合念珠菌培养物（40%和 52%）：两组中均更常发现白色念珠菌，HIV+中更常见（P=0.05）；其他非白色念珠菌种在 HIV+和 HIV-中分离。HIV+中口腔表现的患病率较低（OC 为 10.7%）。CDT 的平均值与念珠菌生长之间存在关联（P<0.05），HIV+和 HIV-中 CDT 数量与念珠菌 cfu 计数之间存在正相关。CD4%平均值和免疫状态对念珠菌分离没有影响。未接受抗逆转录病毒治疗和 HAART 增加了念珠菌分离的可能性（P<0.05）。
与未感染的兄弟姐妹相比，HIV 感染儿童口腔念珠菌的患病率显著更高。HAART 缺失和有牙本质龋坏牙显著增加了这些儿童的念珠菌定植。
