Hicks M J, Carter A B, Rossmann S N, Demmler G J, Simon C L, Cron S G, Flaitz C M, Shearer W T, Kline M W
Department of Pathology, Baylor College of Medicine, Houston, Texas, USA.
Pediatr Dent. 1998 May-Jun;20(3):162-8.
Fungal infections in HIV-infected individuals are associated with advancement of disease. In pediatric HIV infection, symptomatic children have a significantly higher incidence of clinical candidiasis and persistent drug-resistant candidiasis than do asymptomatic HIV-infected children. The purpose of this preliminary cytologic study was to determine the prevalence of fungal organisms in whole unstimulated saliva from children with vertically acquired HIV infection.
The subjects included 27 HIV-infected and 11 HIV-exposed, but uninfected, children. Whole unstimulated saliva was obtained for cytologic evaluation (hematoxylin and eosin, silver stains) with selected samples evaluated by electron microscopy.
Yeast and hyphae were identified cytologically in 19% of HIV-infected (22% symptomatic HIV-infected, 11% asymptomatic HIV-infected) and 9% of HIV-exposed, but uninfected, children. Fungal organisms were found more frequently in HIV-infected with moderate (18%) and severe (27%) suppression. Fungi were more frequent with antiretroviral therapy (22%) vs no antiretroviral therapy (0%) and no antifungal therapy (20%) vs. antifungal therapy (7%). Yeast and hyphal fungal forms are more prevalent in symptomatic HIV-infection with moderate and severe suppression, and those receiving antiretroviral agents, but no antifungal medications.
Fungal organisms in the saliva may reflect oral carriage or mucosal colonization, which may influence the development of clinically significant candidiasis in these immunocompromised children.
HIV感染个体中的真菌感染与疾病进展相关。在儿童HIV感染中，有症状的儿童临床念珠菌病和持续性耐药念珠菌病的发病率显著高于无症状HIV感染儿童。这项初步细胞学研究的目的是确定垂直感染HIV的儿童未受刺激的全唾液中真菌生物体的流行情况。
研究对象包括27名HIV感染儿童和11名暴露于HIV但未感染的儿童。采集未受刺激的全唾液用于细胞学评估（苏木精和伊红染色、银染色），部分样本通过电子显微镜进行评估。
在19%的HIV感染儿童（22%有症状的HIV感染儿童、11%无症状的HIV感染儿童）和9%暴露于HIV但未感染的儿童的唾液细胞学检查中发现了酵母和菌丝。在HIV感染且免疫抑制程度为中度（18%）和重度（27%）的儿童中，真菌生物体更为常见。接受抗逆转录病毒治疗的儿童中真菌更为常见（22%），而未接受抗逆转录病毒治疗的儿童中未发现真菌（0%）；未接受抗真菌治疗的儿童中真菌更为常见（20%），而接受抗真菌治疗的儿童中真菌较少（7%）。酵母和菌丝真菌形态在有症状的HIV感染且免疫抑制程度为中度和重度的儿童以及接受抗逆转录病毒药物但未接受抗真菌药物治疗的儿童中更为普遍。
唾液中的真菌生物体可能反映口腔携带或黏膜定植情况，这可能会影响这些免疫功能低下儿童临床上显著的念珠菌病的发生发展。
