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1.
Braz J Otorhinolaryngol ; 89(3): 425-431, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36813599

RESUMO

OBJECTIVES: This study aimed to assess the prevalence of oral lesions in patients living with HIV infection and their association with CD4 count, viral load, and antiretroviral therapy in patients with HIV. METHODS: A cross-sectional study was conducted on a sample of 161 patients attending the… All the patients were examined for their oral lesions, current CD4 counts, type, and duration of the therapy. Data analyses were carried out using Chi-Square, Student T/Mann-Whitney, and logistic regression tests. RESULTS: Oral lesions were observed in 58.39% of patients with HIV. Periodontal disease with 78 (48.45%) or without mobility 79 (49.07%) was observed more frequently, followed by hyperpigmentation of oral mucosa 23 (14.29%), Linear Gingival Erythema (LGE) 15 (9.32%), candidiasis pseudomembranous 14 (8.70%). Oral Hairy Leukoplakia (OHL) was observed only in 3 (1.86%). A relationship between periodontal disease with dental mobility and smoking was found (p=0.04), as well duration of treatment (p=1.53e-3) and age (p=0.02). Hyperpigmentation was related to race (p=0.01) and smoking (p=1.30e-6). CD4 count, CD4:CD8 ratio, viral load, or type of treatment were not associated with oral lesions. Logistic regression showed that the duration of treatment has a protective effect on the periodontal disease with dental mobility (OR = 0.28 [-2.27 to -0.25]; p-value=0.03), independent of age or smoking. To hyperpigmentation, the best model included smoking (OR=8.47 [1.18-3.10], p= 1.31e-5), without race or type and duration of treatment. CONCLUSION: Among HIV patients undergoing antiretroviral treatment, oral lesions can be observed, predominantly periodontal disease. Pseudomembranous candidiasis and oral hairy leukoplakia were also observed. No relationship was found between associated oral manifestations in HIV patients and the start of the treatment, TCD4+ and TCD8+ cell count, TCD4:TCD8 ratio, or viral load. The data indicate that there is a protective effect of duration of treatment with relation to periodontal disease with mobility and that hyperpigmentation seems to be more related to smoking than type and duration of treatment. LEVEL OF EVIDENCE: Level 3 (OCEBM Levels of Evidence Working Group*. "The Oxford 2011 Levels of Evidence").


Assuntos
Candidíase Bucal , Infecções por HIV , Hiperpigmentação , Doenças da Boca , Doenças Periodontais , Humanos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Leucoplasia Pilosa/epidemiologia , Leucoplasia Pilosa/complicações , Doenças da Boca/etiologia , Estudos Transversais , Brasil/epidemiologia , Candidíase Bucal/epidemiologia , Candidíase Bucal/complicações , Doenças Periodontais/complicações , Hiperpigmentação/complicações
2.
Oral Dis ; 26 Suppl 1: 22-27, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862536

RESUMO

The significance of the oral manifestations of HIV has been widely recognised since the start of the epidemic. It is estimated that more than 38 million people are living with HIV currently, with more than a third presenting with oral manifestations. Access to optimum clinical management and effective treatment in resource-rich countries has led to a remarkable decrease in some of the oral manifestations in the HIV population but this is not mirrored in developing countries, where most HIV-positive patients reside. In this paper, a review of the literature since the start of the HIV infection in different parts of the world is presented to highlight the current significance of the oral conditions in this population. Oral candidiasis was repeatedly reported as the most encountered oral manifestation of HIV in different countries, including in studies on groups on anti-retroviral therapy. Over time salivary gland disease was reported less in developed countries but was encountered more in developing countries. There is evidence to show that the prevalence of oral warts increased with the establishment of anti-retroviral therapy. A review of the worldwide prevalence of HIV-related oral conditions indicates that except for oral hairy leucoplakia, the prevalence of all other nine commonly reported oral conditions remained the same or increased over time. Oral opportunistic infections in HIV-infected patients are an ongoing clinical burden mainly in developing countries. Maintaining research in the subject and improving access to HIV treatment will help address the oral health inequalities around the world.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS , Candidíase Bucal , Infecções por HIV , Doenças da Boca , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Candidíase Bucal/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Leucoplasia Pilosa/epidemiologia , Leucoplasia Pilosa/etiologia , Doenças da Boca/epidemiologia , Doenças da Boca/etiologia , Prevalência
3.
J Am Acad Dermatol ; 82(5): 1117-1123, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31499147

RESUMO

BACKGROUND: Because of reduced mortality, patients with HIV are living longer and presenting with chronic diseases. Little is known about racial differences in dermatologic conditions associated with HIV infection. OBJECTIVE: This study examines associated dermatologic conditions in a large population of patients with HIV at a tertiary care center with a diverse patient population. METHODS: Cross-sectional study of patients with HIV seen between July 14, 2013, and July 14, 2018, in a tertiary health care system. The burden of HIV-related dermatologic conditions was collected by using medical records. Patients with HIV were compared with control individuals of the same race, and significance was assessed using the chi-square test. A Bonferroni correction was performed to control for multiple hypothesis testing. RESULTS: The study population (N = 4679) was 64.7% male and 69% African American, with 88.7% of patients receiving antiretroviral therapy. African American patients with HIV had a greater risk of oral hairy leukoplakia (odds ratio [OR], 64.49), herpes zoster (OR, 9.27), prurigo nodularis (OR, 8.80), and squamous cell carcinoma (OR, 5.72). LIMITATIONS: Our data describe patients seen by 1 health care system. CONCLUSIONS: African American patients with HIV may be at increased risk for pruritic disorders compared with race-matched control individuals and white patients with HIV.


Assuntos
Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Adulto , Distribuição por Idade , Antirretrovirais/uso terapêutico , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Herpes Zoster/diagnóstico , Herpes Zoster/epidemiologia , Hospitais Urbanos , Humanos , Incidência , Leucoplasia Pilosa/diagnóstico , Leucoplasia Pilosa/epidemiologia , Masculino , Pessoa de Meia-Idade , Prurido/diagnóstico , Prurido/epidemiologia , Fatores Raciais , Estudos Retrospectivos , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/epidemiologia , Distribuição por Sexo , Dermatopatias/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Centros de Atenção Terciária , Estados Unidos/epidemiologia
4.
Braz Oral Res ; 30(1): e118, 2016 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-27901200

RESUMO

Oral manifestations are common findings in human immunodeficiency virus (HIV) infected patients and frequently influence the overall health. Oral hairy leukoplakia (OHL) is strongly associated with HIV infection demonstrating its relationship with the individual's immune status and progression of immunosuppression. This study aims to retrospectively evaluate OHL in HIV patients, analyzing its incidence, demographic aspects and possible changes in clinical and epidemiological profile of the disease over 17 years. The records of 1600 HIV-infected patients were reviewed. The data were correlated and analyzed, considering HIV exposure category, age, gender, harmful habits, CD4 level, use and type of antiretroviral. OHL was observed in 215 (13.4%) patients. Most were men in the fourth decade of life, 171 (79.5%) and 112 (52,1%) respectively, but an increase in the incidence of OHL among female patients and those in the fifth decade of life was observed. Tobacco smoking was the most frequent harmful habit reported by 114 (68%) patients. OHL occurred mostly in patients with CD4 counts between 200 and 500 cells/mm3 35 (55.5%). The lower incidence of OHL was found among patients using at least one non-nucleoside reverse transcriptase inhibitor (NNRTI). OHL is related to CD4 count, use of ARVT and tobacco smoking and is also more prevalent in men in the fourth decade of life. These characteristics were recognized in absolute values, but when verifying the behavior over the years we noticed that the incidence of OHL is decreasing and its epidemiological characteristics changing.


Assuntos
Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Leucoplasia Pilosa/epidemiologia , Leucoplasia Pilosa/etiologia , Fatores Etários , Brasil/epidemiologia , Contagem de Linfócito CD4 , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos
5.
Braz. oral res. (Online) ; 30(1): e118, 2016. tab, graf
Artigo em Inglês | LILACS | ID: biblio-952040

RESUMO

Abstract Oral manifestations are common findings in human immunodeficiency virus (HIV) infected patients and frequently influence the overall health. Oral hairy leukoplakia (OHL) is strongly associated with HIV infection demonstrating its relationship with the individual's immune status and progression of immunosuppression. This study aims to retrospectively evaluate OHL in HIV patients, analyzing its incidence, demographic aspects and possible changes in clinical and epidemiological profile of the disease over 17 years. The records of 1600 HIV-infected patients were reviewed. The data were correlated and analyzed, considering HIV exposure category, age, gender, harmful habits, CD4 level, use and type of antiretroviral. OHL was observed in 215 (13.4%) patients. Most were men in the fourth decade of life, 171 (79.5%) and 112 (52,1%) respectively, but an increase in the incidence of OHL among female patients and those in the fifth decade of life was observed. Tobacco smoking was the most frequent harmful habit reported by 114 (68%) patients. OHL occurred mostly in patients with CD4 counts between 200 and 500 cells/mm3 35 (55.5%). The lower incidence of OHL was found among patients using at least one non-nucleoside reverse transcriptase inhibitor (NNRTI). OHL is related to CD4 count, use of ARVT and tobacco smoking and is also more prevalent in men in the fourth decade of life. These characteristics were recognized in absolute values, but when verifying the behavior over the years we noticed that the incidence of OHL is decreasing and its epidemiological characteristics changing.


Assuntos
Humanos , Masculino , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Leucoplasia Pilosa/etiologia , Leucoplasia Pilosa/epidemiologia , Brasil/epidemiologia , Fumar/efeitos adversos , Modelos Logísticos , Fatores Sexuais , Incidência , Estudos Retrospectivos , Fatores de Risco , Fatores Etários , Contagem de Linfócito CD4
6.
Int J Dermatol ; 54(10): 1169-74, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26394603

RESUMO

BACKGROUND: In Ethiopia, skin diseases are among the leading causes of outpatient attendance to primary health service. Correlation of skin diseases and HIV has long been recognized and used to guide medical management in resource-limited settings. Therefore, this study aims to assess the correlation of skin diseases and HIV infection, to estimate epidemiological distribution in the study area, and to provide health workers of skin indicators for HIV early detection. METHODS: The operational research was designed as a case-control study and carried out in three intervention districts of Tigray region; baseline and final data on skin diseases and HIV were compared with those of three control districts matched for population size, density, and environmental characteristics. Health workers of intervention districts were trained on skin diseases/STIs diagnosis and treatment. Data were collected from study and control districts and then analyzed at the Italian Dermatological Centre (IDC) in Mekele. RESULTS: In the research period, a total of 1044 HIV positive patients were detected. Disorders of skin and mucous membranes statistically related with HIV (P < 0.05) were tongue papillary atrophy (80%), oral hairy leukoplakia (69%), herpes zoster (66%), oral candidiasis (50%), pruritic papular eruption (43%), condylomata acuminata (38%), and telogen effluvium (27%). CONCLUSIONS: The high frequency of oral disorders and telogen effluvium is not described in literature and may be indicative for case detection. Operational research offers significant gains on health service delivery and outcomes at relatively low cost and in a short timeframe.


Assuntos
Infecções por HIV/epidemiologia , Dermatopatias/epidemiologia , Adulto , Candidíase Bucal/epidemiologia , Estudos de Casos e Controles , Condiloma Acuminado/epidemiologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/diagnóstico , Doenças do Cabelo/epidemiologia , Herpes Zoster/epidemiologia , Humanos , Leucoplasia Pilosa/epidemiologia , Masculino , Prevalência , Prurigo/epidemiologia , Doenças da Língua/epidemiologia
7.
Int Marit Health ; 65(3): 124-30, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25471161

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) infection is a major global health problem. Tuberculosis and cryptococcal meningitis are the leading cause of death among people living with HIV. AIM: The purpose of this study was to determine whether any relationship exists between the occurrence of oral lesions and opportunistic infections among HIV-infected patients in Indian population. MATERIALS AND METHODS: A cross-sectional analytical study was performed in 232 HIV-infected persons (148 males and 84 females, aged 20-60 years, mean 33.6 ± 2.3 years). c2 test and logistic regression were used for statistical analysis. RESULTS: Oral candidiasis was the most common oral lesion seen in 28.4% males and 22.6% females of HIV-infected persons, followed by hairy leukoplakia in 27% males and 20.2% females which was statistically significant. Tuberculosis (21.6%) followed by cryptococcosis (9.9%) and pneumocystis carinii pneumonia (4.7%) were the most commonly found opportunistic infections. Logistic regression analysis revealed a significant association, between the occurrence of tuberculosis and candidiasis (OR 2.3; 95% CI 1.4-2.9), cryptococcosis and candidiasis (OR 1.4; 95% CI 1.0-1.9), and pneumocystis carinii pneumonia with hairy leukoplakia (OR 1.6; 95% CI 1.0-2.9). Mean CD4 count was also less. CONCLUSIONS: The results suggest a definite relationship in occurrence of oral lesions and opportunistic infections among HIV-infected patients.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Candidíase Bucal/epidemiologia , Leucoplasia Pilosa/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Contagem de Linfócito CD4 , Candidíase Bucal/imunologia , Estudos Transversais , Criptococose/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Leucoplasia Pilosa/imunologia , Masculino , Pessoa de Meia-Idade , Pneumonia por Pneumocystis/epidemiologia , Fatores Sexuais , Tuberculose Pulmonar/epidemiologia , Adulto Jovem
8.
Saudi J Kidney Dis Transpl ; 25(2): 278-84, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24625992

RESUMO

Renal transplantation is considered the best treatment option for patients with end-stage renal disease. In this study, the prevalence of oral lesions was studied in a cohort of renal transplant recipients before and after transplantation. Fifty-nine kidney transplant recipients were examined one week before and four months after transplantation. The information gathered included age, sex, smoking history, duration on dialysis, drugs and their doses. There were 41 males (69.5%) and 18 females (30.5%) with a mean age of 37 years. Before surgery, two patients had non-specific lesions and two other patients had leukoedema. Following transplantation, 24 patients (40.7%) did not have any specific lesion. In six patients, we observed non-specific erythematous lesions (10.2%). Other recorded observations are as follows: Gingival hyperplasia in five patients (8.5%), oral candidiasis of the erythematous type in five patients (8.5%), hairy leukoplakia in four patients (6.8%) and leukoedema in seven patients (11.9%). In our study patients, the prevalence of oral lesions increased after transplantation, although it was lower than that reported in other studies. This could be due to the differences in sample size, differences between Iranian race and other races and different pharmaceutical formulation of the drug produced in Iran.


Assuntos
Candidíase Bucal/imunologia , Hiperplasia Gengival/imunologia , Transplante de Rim , Adolescente , Adulto , Idoso , Aloenxertos , Candidíase Bucal/epidemiologia , Candidíase Bucal/genética , Feminino , Predisposição Genética para Doença , Hiperplasia Gengival/epidemiologia , Hiperplasia Gengival/genética , Humanos , Irã (Geográfico)/epidemiologia , Leucoplasia Pilosa/epidemiologia , Leucoplasia Pilosa/genética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
Int J Dermatol ; 52(10): 1177-84, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24073903

RESUMO

Epstein-Barr virus (EBV) is a human B-lymphotropic herpes virus and one of the most common viruses in humans. Specific skin signs related to EBV infection are the exanthem of mononucleosis, which is observed more frequently after ingestion of amoxicillin, and oral hairy leukoplakia, a disease occurring mostly in immunocompromised subjects with HIV infection. Other more uncommon cutaneous disorders that have been associated with EBV infection include virus-related exanthems or diseases such as Gianotti-Crosti syndrome, erythema multiforme, and acute genital ulcers. Other skin manifestations, not correlated to virus infection, such as hydroa vacciniforme and drug-induced hypersensitivity syndrome have also been linked to EBV. The putative involvement of EBV in skin diseases is growing similarly to other areas of medicine, where the role of EBV infection is being investigated in potentially debilitating inflammatory diseases. The prognosis of EBV infection in healthy, immunocompetent individuals is excellent. However, lifelong infection, which is kept in check by the host immune system, determines an unpredictable risk of pathologic unpredictable scenarios. In this review, we describe the spectrum of non-tumoral dermatological manifestations that can follow EBV primary infection or reactivation of EBV in childhood.


Assuntos
Infecções por Vírus Epstein-Barr/diagnóstico , Exantema/diagnóstico , Exantema/virologia , Mononucleose Infecciosa/diagnóstico , Acrodermatite/diagnóstico , Acrodermatite/epidemiologia , Acrodermatite/virologia , Criança , Infecções por Vírus Epstein-Barr/epidemiologia , Exantema/epidemiologia , Humanos , Hidroa Vaciniforme/diagnóstico , Hidroa Vaciniforme/epidemiologia , Hidroa Vaciniforme/virologia , Mononucleose Infecciosa/epidemiologia , Leucoplasia Pilosa/diagnóstico , Leucoplasia Pilosa/epidemiologia , Leucoplasia Pilosa/virologia
10.
Int Dent J ; 63(4): 189-95, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23879254

RESUMO

AIM: The purpose of this study was to compare gender differences in the prevalence of oral lesions in HIV-infected Brazilian adults. METHODOLOGY: A retrospective study was conducted of medical records from HIV/AIDS patients from 1993 to 2004. Oral lesions were only included in this study if definitively diagnosed through microscopic analysis, therapeutic test or according to EC-Clearing house criteria. RESULTS: A total of 750 men and 237 women were included in the study. Statistically significant differences were observed only for oral hairy leukoplakia, Kaposi sarcoma and lymphadenopathy (P < 0.01). However, a model of logistic regression showed that only oral hairy leukoplakia presented a significant association with gender and males had a significantly likelihood (four times higher than females) of presenting with this oral manifestation [OR 4.3 (95% CI: 1.39-13.36)]. CONCLUSION: These data shows that oral manifestations are less prevalent in females than in males, particularly oral hairy leukoplakia.


Assuntos
Infecções por HIV/complicações , Doenças da Boca/etiologia , Adolescente , Adulto , Brasil/epidemiologia , Candidíase Bucal/epidemiologia , Candidíase Bucal/etiologia , Feminino , Gengivite Ulcerativa Necrosante/epidemiologia , Gengivite Ulcerativa Necrosante/etiologia , Infecções por HIV/epidemiologia , Humanos , Leucoplasia Pilosa/epidemiologia , Leucoplasia Pilosa/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
11.
J Oral Sci ; 53(3): 379-85, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21959667

RESUMO

We estimated the prevalence of oral lesions associated with human immunodeficiency virus (HIV-OLs) before and during the antiretroviral therapy (ART) era. The first period was 1997, when many patients received two types of antiretroviral (ARV) drugs. The second study period was 2004 through 2008, when all patients were treated with ART (a combination of two or three classes of drugs, including protease inhibitors). A total of 148 and 388 seropositive participants were examined in 1997 and 2004-2008, respectively. The evaluation consisted of anamnesis and physical examination. The prevalence of HIV-OLs decreased between 1997 (60.1%) and 2004-2008 (29.9%). The HIV-OL responsible for the greatest reduction in prevalence between the two periods was oral candidiasis, of which erythematous candidiasis was the clinical form that decreased most, followed by pseudomembranous candidiasis. In conclusion, we observed a significant reduction in HIV-OLs, which was closely associated with the use of ART. In addition, among patients with a clinical diagnosis of AIDS, we confirmed a significant reduction in HIV-OL prevalence between 1997 and 2004-2008.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Doenças da Boca/complicações , Doenças da Boca/epidemiologia , Adulto , Terapia Antirretroviral de Alta Atividade/estatística & dados numéricos , Brasil/epidemiologia , Contagem de Linfócito CD4 , Candidíase Bucal/complicações , Candidíase Bucal/epidemiologia , Queilite/complicações , Queilite/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Leucoplasia Pilosa/complicações , Leucoplasia Pilosa/epidemiologia , Masculino , Prevalência
12.
South Med J ; 104(8): 561-6, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21886064

RESUMO

OBJECTIVE: Our aim was to quantify prevalence, incidence, and recurrence of oral lesions (OL) among a population in the Southeast. METHODS: A retrospective study based on chart review was conducted among patients (n = 744) who were ≥19 years of age and initiated highly active antiretroviral therapy (HAART) between January 2000 and June 2006 at the University of Alabama at Birmingham (UAB) 1917 Clinic. Patients' laboratory data and oral conditions were recorded for 2 years after enrollment into the study. RESULTS: During 2 years of follow-up, the period prevalence of individuals experienced at least one OL was 35.6% (266/744). Among all of the 374 episodes of OL, 183 were new cases, while 57 were recurrences. The OL person-visit incidence rate was 0.02 per 100 person-visits. Oropharyngeal candidiasis (OPC) was the most frequent manifestation in terms of period prevalence (74.9%) with a person-visit incident rate of 0.01 per 100 person-visits. CONCLUSIONS: Patients undergoing HAART continue to be affected by HIV-related oral conditions, especially OPC. These results clearly indicate that OL during HIV infection are still highly prevalent in spite of the improvements in medical care and the availability of HAART.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Doenças da Boca/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/complicações , Adulto , Idoso , Alabama/epidemiologia , Candidíase Bucal/complicações , Candidíase Bucal/epidemiologia , Feminino , Infecções por HIV/complicações , Humanos , Incidência , Leucoplasia Pilosa/complicações , Leucoplasia Pilosa/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças da Boca/complicações , Visita a Consultório Médico , Úlceras Orais/complicações , Úlceras Orais/epidemiologia , Prevalência , Recidiva , Estudos Retrospectivos , Estomatite Herpética/complicações , Estomatite Herpética/epidemiologia , Adulto Jovem
13.
Int J Paediatr Dent ; 20(4): 276-82, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20536589

RESUMO

BACKGROUND: Lesions in the mouth and in other tissues and organs (oral and systemic lesions) in paediatric HIV infection are diverse and show differences in clinical presentation and severity from that of adults. Very little data exist for oral lesions in paediatric population in India. AIM: To document and study oral and more widespread lesions in paediatric HIV seropositive patients. DESIGN: A cross-sectional study. SETTING: Paediatric HIV seropositive patients at tertiary centers: Ragas Dental College and Hospital and YRG CARE, Chennai, India. PATIENTS AND METHODS: Two hundred and twelve paediatric HIV patients aged 0-14 years seen over a period of 1 year were included in the study. Clinical history, oral and systemic examinations were recorded by qualified dental surgeons and physicians. RESULTS: One hundred and thirty-two patients had oral lesions ranging in number from one to three. Oral lesions included oral candidiasis (OC) (56.1%), gingivitis (10.8%), oral pigmentation (6.1%), depapillation of the tongue (5.7%), ulcers (4.2%), and oral hairy leukoplakia (1.4%). The most common systemic lesion observed was nonspecific lymphadenopathy (74.1%) followed by pruritic eruptions (53.8%), measles (51.4%), and tuberculosis (TB) (49.1%). Thirty-three (26%) patients were not immunosuppressed, 74 (58%) were moderately immunosuppressed, and 20 (15%) were severely immunosuppressed. Oral lesions exhibited positive correlation with lesions in other parts of the body. CONCLUSION: Oral lesions are a common feature in paediatric HIV infection. Their management is vital to improve the quality of life of the infected children.


Assuntos
Infecções por HIV/epidemiologia , Soropositividade para HIV/epidemiologia , Doenças da Boca/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adolescente , Contagem de Linfócito CD4 , Candidíase Bucal/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Gengivite/epidemiologia , Infecções por HIV/transmissão , Soropositividade para HIV/transmissão , Humanos , Hospedeiro Imunocomprometido , Índia/epidemiologia , Lactente , Leucoplasia Pilosa/epidemiologia , Doenças Linfáticas/epidemiologia , Masculino , Sarampo/epidemiologia , Úlceras Orais/epidemiologia , Otite Média/epidemiologia , Transtornos da Pigmentação/epidemiologia , Prurido/epidemiologia , Papilas Gustativas/patologia , Doenças da Língua/epidemiologia , Tuberculose Pulmonar/epidemiologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-20303299

RESUMO

OBJECTIVES: Attendees presenting for treatment of acute illness at primary health care facilities in South Africa were assessed to determine the prevalence of human immunodeficiency virus (HIV) infection and the predictability of group I oral lesions (GOLs) for HIV infection. METHODS: This was a cross-sectional analytical study. Patients >18 years of age were recruited and underwent an oral examination and a HIV test. RESULTS: A total of 522 attendees were examined and the HIV prevalence was 40%. None of them were taking antiretroviral drugs. GOLs were diagnosed in 53% of HIV patients, with pseudomembranous and erythematous candidiasis being the most common (38% and 24%, respectively). The average odds and likelihood ratios for multiple lesions were high (32 and 30, respectively) and showed a strong correlation between GOLs and a positive HIV status. CONCLUSION: The prevalence of HIV (40%) and GOLs (53%) was high. GOLs were useful markers of HIV infection, with multiple lesions being highly predictive of HIV infection.


Assuntos
Infecções por HIV/epidemiologia , Doenças da Boca/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candidíase Bucal/epidemiologia , Queilite/epidemiologia , Estudos Transversais , Feminino , Previsões , Soropositividade para HIV/epidemiologia , Humanos , Leucoplasia Pilosa/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , África do Sul/epidemiologia , Adulto Jovem
15.
J Oral Pathol Med ; 38(6): 489-94, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19453845

RESUMO

BACKGROUND: The incidence of oral lesions related to human immunodeficiency virus (HIV) infection have been investigated after treatment with highly active antiretroviral therapy (HAART) including protease inhibitors (PI) but no data are available on the effect of non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy on incidence of acquired immunodeficiency syndrome (AIDS) oral manifestations or impact of HAART on oral manifestations of HIV infection in Brazil. The aim of this study was to describe the effects of anti-HIV therapy on the incidence of oral lesions during 17 years of AIDS epidemics in a Brazilian population. METHODS: From 1989 to 2006, we collected data from 1595 consecutive HIV patients at the Special Care Dentistry Center, São Paulo, Brazil. We compared the effect of PI- and NNRTI-based antiretroviral therapy (ARVT) on the annual incidence of Kaposi sarcoma (KS), oral candidiasis (OC) and hairy leukoplakia (HL). The chi-squared test was used to test the association between oral lesions and therapeutic regimen (P < 0.05). RESULTS: None of patients on ARVT presented with KS. Patients who used (nucleoside reverse transcriptase inhibitors) NRTI + PI were 0.9 times as likely to present with HL as those who used NRTI + NNRTI. This finding, however, was not statistically significant (P = 0.5). The relative risk for OC was 0.8 in patients with PI-based HAART. The increased risk among those on PIs was statistically significant (P = 0.004). CONCLUSIONS: The superiority of NNRTI regimens in decreasing OC incidence is consistent with current therapeutic guidelines which recommend NNRTI-based therapy as the treatment of choice for initial ARVT.


Assuntos
Terapia Antirretroviral de Alta Atividade , Inibidores da Protease de HIV/uso terapêutico , Doenças da Boca/epidemiologia , Inibidores da Transcriptase Reversa/uso terapêutico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Antirretrovirais/uso terapêutico , Brasil/epidemiologia , Contagem de Linfócito CD4 , Candidíase Bucal/epidemiologia , Queilite/epidemiologia , Estudos de Coortes , Condiloma Acuminado/epidemiologia , Eritema/epidemiologia , Seguimentos , Doenças da Gengiva/epidemiologia , Gengivite Ulcerativa Necrosante/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Incidência , Leucoplasia Pilosa/epidemiologia , Linfoma Relacionado a AIDS/epidemiologia , Neoplasias Bucais/epidemiologia , Sarcoma de Kaposi/epidemiologia , Estomatite Aftosa/epidemiologia , Estomatite Herpética/epidemiologia
16.
Oral Maxillofac Surg ; 13(2): 63-8, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19404695

RESUMO

PURPOSE: The purpose of this study is to review the Chinese-language medical and dental literature from 1982 to 2008 on oral manifestations (OMs) of patients with HIV/AIDS for introducing the spectrum of OMs of the patients in China. MATERIALS AND METHODS: All data were extracted from 18 references which had used diagnostic criteria for HIV/AIDS. Four of the references had used the EC-Clearinghouse classification for oral lesions in HIV infection. The feasible overall rate and 95% confidence interval (95%CI) of the data on OMs were calculated. RESULTS: Risk group analysis revealed that, of 203 patients, 64.3% were men and 35.7% were women (age range, 5 months to 64 years; mean age in three studies, 34.0, 34.3, and 36.1 years). Of these patients, 22.2% were infected by sexual contacts, 11.8% by intravenous drug use (IDU), 59.6% by blood or its products, 2.9% by mother to child transmission, and 3.4% were unclear. In 203 patients, oral candidiasis (OC) was the most common lesion (66%, 95%CI = 59.48-72.52%), followed by herpes simplex (HS) (22.2%, 95%CI = 16.48-27.92%), ulcerative stomatitis (14.8%, 95%CI = 9.92-19.68%), salivary gland disease (11.3%, 95%CI = 6.94-15.66%), oral hairy leukoplakia (OHL) (9.8%, 95%CI = 5.71-13.89%), necrotizing gingivitis (5.9%, 95%CI = 2.66-9.14%), Kaposi's sarcoma (2.9%, 95%CI = 0.59-5.21%), other malignant tumors (2.9%, 95%CI = 0.59-5.21%), and linear gingival erythema (2.0%, 95%CI = 0.07-3.93%). CONCLUSIONS: The spectrum of OMs reported from China is similar to that described in the international literature. Present data are useful to supplement international resources of HIV/AIDS research.


Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Doenças da Boca/epidemiologia , Síndrome da Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Idoso , Transfusão de Sangue/estatística & dados numéricos , Patógenos Transmitidos pelo Sangue , Candidíase Bucal/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Gengivite Ulcerativa Necrosante/epidemiologia , Infecções por HIV/transmissão , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Leucoplasia Pilosa/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Estudos Retrospectivos , Doenças das Glândulas Salivares/epidemiologia , Sarcoma de Kaposi/epidemiologia , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Estomatite Herpética/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto Jovem
17.
J Oral Pathol Med ; 38(1): 126-31, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19192058

RESUMO

BACKGROUND: Studies on the prevalence of HIV-related oral lesions (HIV-OL) have shown great variations among different countries. The aim of this study was to describe the prevalence of HIV-OL in adults infected with HIV in the province of Sancti Spiritus, Cuba, and to determine the factors associated with the presence of HIV-OL. METHODS: A cross-sectional observational study was performed between November 2006 and August 2007 at the Hospital General Universitario 'Camilo Cienfuegos', Sancti Spiritus. One hundred and fifty-four HIV-infected patients were included. Patients were examined and interviewed by a periodontal specialist. Diagnosis of HIV-OL was based on clinical criteria. Demographical, clinical and laboratory data were obtained. Independent association of each factor with HIV-OL was assessed by logistic regression modelling. RESULTS: The prevalence of HIV-OL was 40.9%. The commonest manifestation was oral hairy leucoplakia (n = 19; 12.3%); oral candidiasis (n = 17; 11%); herpes simplex virus infection (n = 11; 7.4%); and aphthous ulcer (n = 9; 5.8%). Principal factors associated with the presence of HIV-OL were CD4(+) lymphocytes <500 cells/mm(3) (OR: 2.06; 95% CI: 1.019-4.195) and smoking (OR: 2.03 CI: 1.037-3.982). CONCLUSION: This study described the prevalence of HIV-OL in 154 HIV-infected patients which represent about 80% of those known to be infected in the province of Sancti Spiritus. The prevalence of HIV-OL was lower than those reported from developing countries. Oral hairy leucoplakia and oral candidiasis were the most prevalent HIV-OL. Smoking and CD4(+) cells count <500 cells/mm(3) were the two factors independently associated with the presence of HIV-OL.


Assuntos
Infecções por HIV/epidemiologia , Doenças da Boca/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adolescente , Adulto , Contagem de Linfócito CD4 , Candidíase Bucal/epidemiologia , Estudos Transversais , Cuba/epidemiologia , Feminino , Gengivite/epidemiologia , Humanos , Leucoplasia Pilosa/epidemiologia , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Periodontite/epidemiologia , Prevalência , Fatores de Risco , Fumar/epidemiologia , Estomatite Aftosa/epidemiologia , Estomatite Herpética/epidemiologia , Carga Viral , Adulto Jovem
18.
J Appl Oral Sci ; 16(6): 369-75, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19082393

RESUMO

The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count). Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37) presented some type of oral lesion. Candidiasis (28%) and periodontal disease (28%) were the most common, followed by cervical-facial lymphadenopathy (17.5%). Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous), herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.


Assuntos
Soropositividade para HIV/epidemiologia , Doenças da Boca/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Contagem de Linfócito CD4 , Candidíase Bucal/epidemiologia , Dentaduras/estatística & dados numéricos , Estudos Epidemiológicos , Feminino , Heterossexualidade/estatística & dados numéricos , Hospitais Especializados , Humanos , Hiperpigmentação/epidemiologia , Leucoplasia Pilosa/epidemiologia , Doenças Linfáticas/epidemiologia , Masculino , Doenças Periodontais/epidemiologia , Prevalência , Grupos Raciais/estatística & dados numéricos , Assunção de Riscos , Fatores Sexuais , Fumar/epidemiologia , Estomatite Aftosa/epidemiologia , Estomatite Herpética/epidemiologia , Adulto Jovem
19.
J. appl. oral sci ; 16(6): 369-375, Nov.-Dec. 2008. graf, tab
Artigo em Inglês | LILACS | ID: lil-499883

RESUMO

The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count). Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37) presented some type of oral lesion. Candidiasis (28%) and periodontal disease (28%) were the most common, followed by cervical-facial lymphadenopathy (17.5%). Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous), herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.


Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Soropositividade para HIV/epidemiologia , Doenças da Boca/epidemiologia , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Candidíase Bucal/epidemiologia , Grupos Raciais/estatística & dados numéricos , Dentaduras/estatística & dados numéricos , Estudos Epidemiológicos , Hospitais Especializados , Heterossexualidade/estatística & dados numéricos , Hiperpigmentação/epidemiologia , Leucoplasia Pilosa/epidemiologia , Doenças Linfáticas/epidemiologia , Prevalência , Doenças Periodontais/epidemiologia , Assunção de Riscos , Fatores Sexuais , Fumar/epidemiologia , Estomatite Aftosa/epidemiologia , Estomatite Herpética/epidemiologia , Adulto Jovem
20.
J Public Health Dent ; 68(3): 178-81, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18248345

RESUMO

OBJECTIVES: We investigated the oral manifestations of HIV-infected patients in Salvador, Brazil, and their relationship to immunologic, sociodemographic, and therapeutic factors. METHODS: This was a cross-sectional study that used data from adult patients' medical records in the dentistry service of the AIDS Reference Center in Salvador, Brazil. We reviewed the patients' records to collect information concerning oral health status and data on socioeconomic status, immunologic status, and treatment. RESULTS: A total of 993 patients were included in the study, of whom 473 (47.6 percent) were male. Approximately 5.5 percent of the patients presented with any oral lesions. Oral lesions were the most common in the patients with fewer than 350 CD4+ T lymphocytes (8.4 percent) and with viral loads greater than 10,000 copies (8.3 percent). CONCLUSIONS: Our study shows that lesions are more common in patients with advanced immune suppression and low level of schooling. Oral candidiasis and angular chelitis were the most common lesions seen.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Doenças da Boca/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Contagem de Linfócito CD4 , Candidíase Bucal/epidemiologia , Queilite/epidemiologia , Estudos Transversais , Escolaridade , Emprego/estatística & dados numéricos , Feminino , Infecções por HIV/imunologia , Infecções por HIV/virologia , Nível de Saúde , Humanos , Leucoplasia Pilosa/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Saúde Bucal , Sarcoma de Kaposi/epidemiologia , Classe Social , Estomatite Herpética/epidemiologia , Carga Viral , Adulto Jovem
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