Rosa Desi Elvhira, Sufiawati Irna
Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia.
Oral Medicine Department, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia.
Int Med Case Rep J. 2023 Jan 30;16:73-82. doi: 10.2147/IMCRJ.S398736. eCollection 2023.
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has a serious impact on HIV-infected individuals due to limited access to treatment services. This report aimed to describe four cases of oral lesions in HIV-infected antiretroviral-naive patients found during the COVID-19 pandemic. CASE: Four patients, males, with an age ranged from 29 to 53 years, came to Oral Medicine Department with chief complaints of lesions on their mouth. They had postponed their visit to healthcare services due to limited access during pandemic. Three patients had just been diagnosed with HIV and had not yet received anti-retrovirus, while 1 patient had not yet been detected with HIV. From the clinical examination and laboratory findings, we diagnosed the lesions with mucous patches, chronic atrophic candidiasis, angular cheilitis, necrotizing ulcerative gingivitis, linear gingival erythema, cytomegalovirus-associated ulcers, and oral hairy leukoplakia. CASE MANAGEMENT: We gave chlorhexidine gluconate 0.2% mouthwash for mucous patches, nystatin oral suspension for chronic atrophic candidiasis, miconazole cream 2% for angular cheilitis, debridement with hydrogen peroxide 1.5% and rinsed with normal saline for necrotizing ulcerative gingivitis, and diphenhydramine hydrochloride and 0.2% chlorhexidine gluconate for CMV ulcers. All patients showed good clinical improvement after the treatments. CONCLUSION: Oral lesions are still commonly found in HIV-infected patients during COVID-19 pandemic. Dentists remain to have a crucial role in the early diagnosis and treatment of HIV-associated oral lesions during COVID-19 pandemic that will have an impact on HIV treatments, also in implementing the Bali Declaration on oral health in HIV/AIDS 2019 to support UNAIDS goal to end AIDS by 2030.
引言:2019年冠状病毒病(COVID-19)大流行对艾滋病毒感染者产生了严重影响,因为他们获得治疗服务的机会有限。本报告旨在描述在COVID-19大流行期间发现的4例未接受过抗逆转录病毒治疗的艾滋病毒感染患者的口腔病变病例。 病例:4名男性患者,年龄在29至53岁之间,因口腔病变为主诉前来口腔内科就诊。由于大流行期间获得医疗服务的机会有限,他们推迟了就诊。3名患者刚被诊断出感染艾滋病毒,尚未接受抗逆转录病毒治疗,而1名患者尚未检测出感染艾滋病毒。通过临床检查和实验室检查结果,我们诊断这些病变为粘膜斑、慢性萎缩性念珠菌病、口角炎、坏死性溃疡性牙龈炎、线性牙龈红斑、巨细胞病毒相关溃疡和口腔毛状白斑。 病例管理:我们给予0.2%葡萄糖酸氯己定漱口水治疗粘膜斑,制霉菌素口服混悬液治疗慢性萎缩性念珠菌病,2%咪康唑乳膏治疗口角炎,用1.5%过氧化氢清创并用生理盐水冲洗治疗坏死性溃疡性牙龈炎,以及盐酸苯海拉明和0.2%葡萄糖酸氯己定治疗巨细胞病毒溃疡。所有患者在治疗后临床症状均有明显改善。 结论:在COVID-19大流行期间,艾滋病毒感染患者中仍普遍存在口腔病变。在COVID-19大流行期间,牙医在艾滋病毒相关口腔病变的早期诊断和治疗中仍发挥着关键作用,这将对艾滋病毒治疗产生影响,同时也有助于实施《2019年艾滋病毒/艾滋病口腔健康巴厘宣言》,以支持联合国艾滋病规划署到2030年终结艾滋病的目标。
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