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成人 HIV 相关口腔病变的危险因素。

Risk factors of HIV-related oral lesions in adults.

机构信息

Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil.

出版信息

Rev Saude Publica. 2013 Feb;47(1):52-9.

Abstract

OBJECTIVE

To assess the risk factors in the occurrence of oral lesions in HIV-positive adults.

METHODS

A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate.

RESULTS

CD4+ counts lower than 350 cells/mm³ (p < 0.001), alcohol consumption (p = 0.011) and female gender (p = 0.031) were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029) a viral load above 5,000 copies/mm³ (p = 0.003) and smoking (p = 0.005).

CONCLUSIONS

Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

摘要

目的

评估 HIV 阳性成年人发生口腔病变的危险因素。

方法

采用回顾性分析-描述性研究方法,对巴西南部阿雷格里港的 534 例与 HIV 相关的口腔病变患者的医疗/牙科记录进行研究。研究数据收集自五个管理 HIV 和相关合并症的转诊中心,时间跨度为 1996 年至 2011 年。使用标准化表格记录社会人口统计学和临床数据。仅纳入并明确诊断的口腔病理学,并根据与 HIV 感染相关的口腔问题的 ECC 标准进行分类。对于数据分析,使用交叉表、卡方检验和逻辑回归模型。

结果

CD4+计数低于 350 个细胞/mm³(p < 0.001)、饮酒(p = 0.011)和女性(p = 0.031)是口腔念珠菌病的易患因素。毛状白斑的发生与 CD4+计数低于 500 个细胞/mm³(p = 0.029)、病毒载量高于 5000 拷贝/mm³(p = 0.003)和吸烟(p = 0.005)独立相关。

结论

中度和重度免疫缺陷以及可检测的病毒载量是口腔病变发生的危险因素。吸烟和饮酒也会增加 HIV 阳性成年人发生机会性感染的易感性,无论是否使用抗逆转录病毒治疗。

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