Bartholo Maria Fernanda, Tenório Jefferson Rocha, Andrade Natália Silva, Silveira Cristiane Barbosa, Ortega Karem López, Martins Fabiana, Gallottini Marina
Universidade de São Paulo - USP, Special Care Dentistry Center, Department of Stomatology, São Paulo, SP, Brazil.
Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry Department of Pathology and Oral Diagnosis, Rio de Janeiro, RJ, Brazil.
Braz Oral Res. 2025 Apr 4;39:e035. doi: 10.1590/1807-3107bor-2025.vol39.035. eCollection 2025.
The objective of this study was to estimate the prevalence of comorbidities among people living with HIV/AIDS (PLWHIV) attending a dental outpatient clinic and discuss the impact of these comorbidities on dental management. A cross-sectional observational study evaluated 238 PLWHIV attending a specialized dental outpatient clinic in Brazil. We collected sociodemographic data, self-reported and physician-diagnosed comorbidities, hemogram results, CD4+ T cell count, viral load, use of combined antiretroviral therapy (cART), and information on harmful habits. The most prevalent comorbidities were sexually transmitted infections (STIs) (116/238; 48.7%), psychiatric disorders (105/238; 44.1%), and lipodystrophy (97/238; 40.8%). Men were more likely to have STIs (OR 4.0) and tuberculosis (OR: 2.5) (p < 0.05). Age ≥ 50 years increased the risk of diabetes mellitus by 2.6 times (p < 0.05). The risk of lipodystrophy (OR: 2.99, 95%CI 1.44-6.19) and psychiatric disorders (OR: 2.13, 95%CI 1.01-4.47) was greater in those who had been diagnosed with HIV for more than 20 years. In summary, psychiatric disorders and severe hematological alterations, such as anemia and neutropenia, are significant comorbidities that may limit dental treatment of HIV-positive patients. These findings underscore the need for integrated medical and dental care to address the complex health needs of PLWHIV.
本研究的目的是估计就诊于牙科门诊的艾滋病毒/艾滋病患者（PLWHIV）中合并症的患病率，并讨论这些合并症对牙科治疗的影响。一项横断面观察性研究评估了238名就诊于巴西一家专门牙科门诊的PLWHIV。我们收集了社会人口学数据、自我报告和医生诊断的合并症、血常规结果、CD4+T细胞计数、病毒载量、联合抗逆转录病毒疗法（cART）的使用情况以及有害习惯信息。最常见的合并症是性传播感染（STIs）（116/238；48.7%）、精神障碍（105/238；44.1%）和脂肪代谢障碍（97/238；40.8%）。男性更易患性传播感染（OR 4.0）和结核病（OR：2.5）（p<0.05）。年龄≥50岁使患糖尿病的风险增加2.6倍（p<0.05）。感染艾滋病毒超过20年的患者发生脂肪代谢障碍（OR：2.99，95%CI 1.44 - 6.19）和精神障碍（OR：2.13，95%CI 1.01 - 4.47）的风险更高。总之，精神障碍和严重血液学改变，如贫血和中性粒细胞减少，是可能限制艾滋病毒阳性患者牙科治疗的重要合并症。这些发现强调了需要综合医疗和牙科护理来满足PLWHIV复杂的健康需求。
