Klein R S, Harris C A, Small C B, Moll B, Lesser M, Friedland G H
N Engl J Med. 1984 Aug 9;311(6):354-8. doi: 10.1056/NEJM198408093110602.
We studied the frequency with which unexplained oral candidiasis led to unequivocal acquired immunodeficiency syndrome (AIDS) in patients at risk. Twenty-two previously healthy adults with unexplained oral candidiasis, of whom the 19 tested had a reversed T4/T8 ratio and 20 had generalized lymphadenopathy, were compared with 20 similar patients with a reversed T4/T8 ratio and generalized lymphadenopathy who did not have oral candidiasis. All were intravenous-drug abusers, homosexual or bisexual men, or both. Thirteen of the 22 patients with oral candidiasis (59 per cent) acquired a major opportunistic infection or Kaposi's sarcoma at a median of three months (range, 1 to 23) as compared with none of 20 patients with generalized lymphadenopathy and immunodeficiency but without candidiasis who were followed for a median of 12 months (range, 5 to 21) (P less than 0.001). AIDS developed in 12 of 15 patients with candidiasis and T4/T8 ratios less than or equal to 0.51, as compared with none of four with ratios equal to or greater than 0.60 (P less than 0.01). We conclude that in patients at high risk for AIDS, the presence of unexplained oral candidiasis predicts the development of serious opportunistic infections more than 50 per cent of the time. Whether the remainder will have AIDS is not yet known.
我们研究了不明原因的口腔念珠菌病在高危患者中导致明确的获得性免疫缺陷综合征（艾滋病）的频率。将22名先前健康的不明原因口腔念珠菌病成人患者与20名类似的患者进行比较，前者中19名检测显示T4/T8比值倒置，20名有全身淋巴结肿大；后者有T4/T8比值倒置和全身淋巴结肿大，但无口腔念珠菌病。所有患者均为静脉注射毒品者、同性恋或双性恋男性，或两者皆是。22名口腔念珠菌病患者中有13名（59%）在中位时间3个月（范围1至23个月）时发生了严重的机会性感染或卡波西肉瘤，而20名有全身淋巴结肿大和免疫缺陷但无念珠菌病的患者在中位时间12个月（范围5至21个月）随访期间均未发生（P<0.001）。15名念珠菌病且T4/T8比值小于或等于0.51的患者中有12名发展为艾滋病，而4名比值等于或大于0.60的患者均未发生（P<0.01）。我们得出结论，在艾滋病高危患者中，不明原因的口腔念珠菌病的存在在超过50%的时间里预示着严重机会性感染的发生。其余患者是否会患艾滋病尚不清楚。
