Shu Wen, Li Chengwen, Du Fei, Bai Jinsong, Duan Kaiwen
Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City.
Department of Research Management, The third affiliated hospital of Kunming Medical University.
Medicine (Baltimore). 2020 Oct 2;99(40):e22416. doi: 10.1097/MD.0000000000022416.
Human immunodeficiency virus (HIV) supresses immune system, primarily cell-mediated immunity. Cluster of differentiation 4 (CD4) cell count, viral load, and oral lesions are the most important laboratory parameters to evaluate the evolution of acquired immunodeficiency syndrome. The present study aims to determine the incidence of HIV-related oral lesions with CD4 cell count and viral load in Yunnan, China.A cross-sectional study was conducted from December 2007 to December 2009, in 1812 HIV positive patients from Department of Infectious Diseases in Kunming Third People's Hospital. CD4, CD8, and viral load data were collected and analyzed statistically using SPSS 11.3.Out of 1812 HIV positive patients, 929 (51.27%) were associated with 1 or more oral lesions. The most common oral lesions observed were Candida Pseudomembranous (13.75%), Candida erythematous (10.93%), Oral hairy leukoplakia (7.95%), Aphthous ulcer (6.18%), Herpes simplex infection (5.58%). In most patients with oral lesions, the CD4 cell count was < 200/μL. The incidence of oral lesions was lower when CD4 count was > 200/μL and with undetectable (P < .01) HIV viral load. Almost no oral lesions was observed when CD4 count > 500/μL (P < .01). With highly active antiretroviral therapy, reduction in HIV-related oral lesions was observed especially in Candida erythematous, Candida Pseudomembranous, Oral hairy leukoplakia, and Aphthous ulcer.The higher incidence of oral lesions with lower CD4 count (<200/μL) in HIV-infected patients indicated importance of CD4 cell count in identifying disease progression.
人类免疫缺陷病毒（HIV）会抑制免疫系统，主要是细胞介导的免疫。分化簇4（CD4）细胞计数、病毒载量和口腔病变是评估获得性免疫缺陷综合征进展的最重要实验室参数。本研究旨在确定中国云南地区HIV相关口腔病变与CD4细胞计数及病毒载量之间的关系。
2007年12月至2009年12月，对昆明市第三人民医院传染病科的1812例HIV阳性患者进行了一项横断面研究。收集了CD4、CD8和病毒载量数据，并使用SPSS 11.3进行统计学分析。
在1812例HIV阳性患者中，929例（51.27%）伴有1种或多种口腔病变。观察到的最常见口腔病变为假膜性念珠菌病（13.75%）、红斑念珠菌病（10.93%）、口腔毛状白斑（7.95%）、阿弗他溃疡（6.18%）、单纯疱疹感染（5.58%）。在大多数有口腔病变的患者中，CD4细胞计数<200/μL。当CD4计数>200/μL且HIV病毒载量不可检测时，口腔病变的发生率较低（P<0.01）。当CD4计数>500/μL时，几乎未观察到口腔病变（P<0.01）。接受高效抗逆转录病毒治疗后，HIV相关口腔病变有所减少，尤其是红斑念珠菌病、假膜性念珠菌病、口腔毛状白斑和阿弗他溃疡。
HIV感染患者中CD4计数较低（<200/μL）时口腔病变发生率较高，这表明CD4细胞计数在识别疾病进展方面具有重要意义。
