Ryder M I
School of Dentistry, University of California at San Francisco.
Curr Opin Periodontol. 1993:43-51.
The HIV-associated periodontal diseases present unique challenges to the dental practitioner. The presence and severity of HIV-associated gingivitis, HIV-associated periodontitis, and possibly necrotizing ulcerative gingivostomatitis, and other oral lesions may indicate the presence and staging of HIV infection. In general, a similar relationship does not appear to exist between adult periodontitis and HIV staging. There is a wide variation in recent reports on the epidemiology of HIV-associated diseases. These variations point to the need for a standard definition for HIV-associated periodontal diseases using both conventional periodontal evaluation criteria and criteria designed specifically for the characteristics of HIV-associated gingivitis and HIV-associated periodontitis. HIV staging, geographic location of the study, antiviral and antimicrobial therapies, and oral habits may also account for many of these differences. Both the HIV-associated gingivitis and periodontitis lesions have similar microbiologic profiles to adult periodontitis lesions for previously identified periodontopathic bacteria. In addition, these lesions may have a unique opportunistic microflora. The pathogenesis of HIV-associated periodontal diseases may be due to the microflora, the effects of HIV and other viral agents, or alterations in the host response. These factors should be taken into consideration in the treatment and prevention of these HIV-associated periodontal lesions.
与人类免疫缺陷病毒（HIV）相关的牙周疾病给牙科医生带来了独特的挑战。HIV相关性牙龈炎、HIV相关性牙周炎，可能还有坏死性溃疡性龈口炎以及其他口腔病变的存在和严重程度，可能表明HIV感染的存在及其分期。一般来说，成人牙周炎与HIV分期之间似乎不存在类似的关系。关于HIV相关疾病的流行病学，近期报告存在很大差异。这些差异表明，需要使用传统的牙周评估标准以及专门针对HIV相关性牙龈炎和HIV相关性牙周炎特征设计的标准，来对HIV相关牙周疾病进行标准定义。HIV分期、研究的地理位置、抗病毒和抗菌治疗以及口腔习惯也可能是造成这些差异的诸多原因。对于先前已确定的牙周病原菌，HIV相关性牙龈炎和牙周炎病变的微生物学特征与成人牙周炎病变相似。此外，这些病变可能有独特的机会性微生物群落。HIV相关牙周疾病的发病机制可能归因于微生物群落、HIV和其他病毒因子的影响，或者宿主反应的改变。在治疗和预防这些HIV相关牙周病变时，应考虑这些因素。
