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围生期感染 HIV 的艾滋病青少年接受抗逆转录病毒治疗后的口腔损害

Oral lesions in HIV+/AIDS adolescents perinatally infected undergoing HAART.

机构信息

Lab. Patología Clínica y Experimental, Fac. Odontología, UNAM, Circuito Institutos s/n, Ciudad Universitaria, Coyoacán 04510, DF, México.

出版信息

Med Oral Patol Oral Cir Bucal. 2010 Jul 1;15(4):e545-50.

Abstract

OBJECTIVE

To assess the prevalence of the oral lesions related to HIV-infection (HIV-OL) in HIV+/AIDS adolescents (=13 years old), and the differences with HIV+/AIDS children (=3 - <13 years old) perinatally infected.

MATERIAL AND METHODS

25 HIV+/AIDS adolescents and 62 HIV+/AIDS children, undergoing Highly Active Antiretroviral Therapy, were orally examined. HIV-OL was diagnosed in accordance with EC-Clearinghouse-World Health Organization. The patients were classifies with respect to their immune status in relation with the CD4+ cell counts as moderately immunodeficient; mildly immunodeficient and severely immunodeficient in accordance to the revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years (CDC-USA). The virological status was established in relation to the copies of RNA-HIV-1/mL as follows: with undetectable viral load (UDVL); with low viral load and with high viral load. A chi-square test was performed (p<0.05 IC95%).

RESULTS

The prevalence of HIV-OL in HIV+/AIDS adolescents was 20% while in HIV/AIDS children was 30.6% (p>0.05). Oral candidiasis was the most prevalent oral lesion in both groups. Association (p<0.05) of a high prevalence of HIV-OL and oral candidiasis with a high viral load was observed in both study groups.

CONCLUSIONS

Adolescents perinatally HIV-infected have a high prevalence of HIV-OL. Oral Candidiasis still is the most frequent oral opportunistic infection. Oral lesions could have association to viral failure in HIV+/AIDS adolescents undergoing HAART.

摘要

目的

评估与 HIV 感染相关的口腔病变(HIV-OL)在 HIV+/AIDS 青少年(=13 岁)中的流行情况,并与经围产期感染的 HIV+/AIDS 儿童(=3-<13 岁)进行比较。

材料和方法

对 25 名 HIV+/AIDS 青少年和 62 名 HIV+/AIDS 儿童进行口腔检查。根据 EC-Clearinghouse-World Health Organization 的标准诊断 HIV-OL。根据修订后的成人、青少年和<18 个月儿童 HIV 感染以及 18 个月至<13 岁儿童 HIV 感染和艾滋病监测病例定义(美国疾病控制与预防中心),根据 CD4+细胞计数将患者的免疫状态分为中度免疫缺陷、轻度免疫缺陷和重度免疫缺陷。病毒学状态与 RNA-HIV-1/ml 的拷贝数有关,分为不可检测病毒载量(UDVL)、低病毒载量和高病毒载量。采用卡方检验(p<0.05,95%可信区间)。

结果

HIV+/AIDS 青少年的 HIV-OL 患病率为 20%,而 HIV/AIDS 儿童为 30.6%(p>0.05)。两组中最常见的口腔病变均为口腔念珠菌病。在两个研究组中,均观察到 HIV-OL 和口腔念珠菌病的高患病率与高病毒载量之间存在关联(p<0.05)。

结论

经围产期感染 HIV 的青少年 HIV-OL 患病率较高。口腔念珠菌病仍然是最常见的口腔机会性感染。在接受高效抗逆转录病毒治疗的 HIV+/AIDS 青少年中,口腔病变可能与病毒失败有关。

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