Patton L L, Ranganathan K, Naidoo S, Bhayat A, Balasundaram S, Adeyemi O, Taiwo O, Speicher D J, Chandra L
Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA.
Adv Dent Res. 2011 Apr;23(1):112-6. doi: 10.1177/0022034511400079.
The workshop considered 5 questions related to oral lesions, HIV phenotypes, and the management of HIV-related disease, with a focus on evidence and challenges in resource-poor settings. First, are oral lesions unique with respect to geographic location or phenotype? Second, how useful would an oral lesion index be to predict HIV in resource-poor countries with no access to CD4 counts or viral load? Third, what are the latest methods and delivery modes for drugs used to treat oral lesions associated with HIV? Fourth, what is the role of the oral health care worker in rapid diagnostic testing for HIV? Fifth, what ethical and legal issues are to be considered when managing the HIV patient? The consensus of the workshop was the need for additional research in 4 key areas in developing countries: (1) additional investigation of comorbidities associated with HIV infection that may affect oral lesion presentation and distribution, especially in pediatric populations; (2) the development of region-specific algorithms involving HIV oral lesions, indicating cumulative risk of immune suppression and the presence of HIV disease; (3) well-designed clinical trials to test new therapies for oral lesions, new treatments for resistant oral fungal and viral diseases, effectiveness of therapies in children, and new drug delivery systems; and (4) the role of the oral health care worker in rapid diagnostic testing for HIV in various regions of the world.
该研讨会审议了5个与口腔病变、艾滋病毒表型以及艾滋病毒相关疾病管理有关的问题，重点关注资源匮乏地区的证据和挑战。第一，口腔病变在地理位置或表型方面是否具有独特性？第二，在无法获得CD4细胞计数或病毒载量检测的资源匮乏国家，口腔病变指数对于预测艾滋病毒感染有多大作用？第三，用于治疗与艾滋病毒相关口腔病变的药物的最新方法和给药方式是什么？第四，口腔保健工作者在艾滋病毒快速诊断检测中扮演什么角色？第五，在管理艾滋病毒患者时需要考虑哪些伦理和法律问题？研讨会达成的共识是，发展中国家需要在4个关键领域开展更多研究：（1）进一步调查可能影响口腔病变表现和分布的与艾滋病毒感染相关的合并症，尤其是在儿童群体中；（2）制定涉及艾滋病毒口腔病变的特定区域算法，以表明免疫抑制的累积风险和艾滋病毒疾病的存在情况；（3）设计完善的临床试验，以测试口腔病变的新疗法、耐药口腔真菌和病毒疾病的新治疗方法、儿童治疗的有效性以及新的药物递送系统；（4）口腔保健工作者在世界各地区艾滋病毒快速诊断检测中的作用。
