Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제43권6호
  • /
  • Pages.388-394
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  • 2017
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
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Oral lesions associated with human immunodeficiency virus in 75 adult patients: a clinical study

  • Berberi, Antoine (Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University) ;
  • Aoun, Georges (Department of Oral Medicine and Diagnosis, School of Dentistry, Lebanese University)
  • 투고 : 2017.07.22
  • 심사 : 2017.09.20
  • 발행 : 2017.12.31
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초록

Objectives: The objective of this study was to investigate the presence of oral lesions in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in a descriptive cross-sectional study, and to establish their presence according to levels of CD4+ cells (including the CD4+/CD8+ cell ratio). Materials and Methods: A total of 75 patients infected with HIV were included. Oral lesions were observed and classified using World Health Organization classification guidelines. Potential correlations between the presence and severity of oral lesions and CD4+ cells, including the CD4+/CD8+ cell ratio, were studied. Results: The most frequent oral lesion detected was oral pseudomembranous candidiasis (80.0%), followed by periodontal disease (40.0%), herpetic lesions (16.0%), hairy leukoplakia (16.0%), gingivitis (20.0%), oral ulceration (12.0%), Kaposi's sarcoma (8.0%), and non-Hodgkin's lymphoma (4.0%). The CD4+ count was <$200cells/mm^3$ in 45 cases (60.0%), between $200-500cells/mm^3$ in 18 cases (24.0%), and >$500cells/mm^3$ in 12 cases (16.0%). The mean CD4+ count was $182.18cells/mm^3$. The mean ratio of CD4+/CD8+ cells was 0.26. All patients showed at least one oral manifestation. Conclusion: There was no correlation between the CD4+/CD8+ cell ratio and the presence of oral lesions. The severity of the lesions was more pronounced when the CD4+ cell count was less than $200cells/mm^3$.

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참고문헌

  1. Patton L. Progress in understanding oral health and HIV/AIDS. Oral Dis 2014;20:223-5. https://doi.org/10.1111/odi.12220
  2. Piot P, Quinn TC. Response to the AIDS pandemic--a global health model. N Engl J Med 2013;368:2210-8. https://doi.org/10.1056/NEJMra1201533
  3. UNAIDS. Global AIDS Response Progress Reporting 2016 [Internet]. Geneva: UNAIDS; January 2016 [cited 2017 Jul 21]. Available from: https://aidsreportingtool.unaids.org/static/docs/GARPR_Guidelines_2016_EN.pdf.
  4. Nesti M, Carli E, Giaquinto C, Rampon O, Nastasio S, Giuca MR. Correlation between viral load, plasma levels of CD4-CD8 T lymphocytes and AIDS-related oral diseases: a multicentre study on 30 HIV+ children in the HAART era. J Biol Regul Homeost Agents 2012;26:527-37.
  5. Patton LL, Ramirez-Amador V, Anaya-Saavedra G, Nittayananta W, Carrozzo M, Ranganathan K. Urban legends series: oral manifestations of HIV infection. Oral Dis 2013;19:533-50. https://doi.org/10.1111/odi.12103
  6. Classification and diagnostic criteria for oral lesions in HIV infection. EC-Clearinghouse on Oral Problems Related to HIV Infection and WHO Collaborating Centre on Oral Manifestations of the Immunodeficiency Virus. J Oral Pathol Med 1993;22:289-91. https://doi.org/10.1111/j.1600-0714.1993.tb01074.x
  7. Petersen PE. Policy for prevention of oral manifestations in HIV/AIDS: the approach of the WHO Global Oral Health Program. Adv Dent Res 2006;19:17-20. https://doi.org/10.1177/154407370601900105
  8. Moniaci D, Greco D, Flecchia G, Raiteri R, Sinicco A. Epidemiology, clinical features and prognostic value of HIV-1 related oral lesions. J Oral Pathol Med 1990;19:477-81. https://doi.org/10.1111/j.1600-0714.1990.tb00790.x
  9. Kolokotronis A, Kioses V, Antoniades D, Mandraveli K, Doutsos I, Papanayotou P. Immunologic status in patients infected with HIV with oral candidiasis and hairy leukoplakia. Oral Surg Oral Med Oral Pathol 1994;78:41-6. https://doi.org/10.1016/0030-4220(94)90115-5
  10. Berberi A, Noujeim Z, Aoun G. Epidemiology of oropharyngeal candidiasis in human immunodeficiency virus/acquired immune deficiency syndrome patients and CD4+ counts. J Int Oral Health 2015;7:20-3.
  11. Ramirez-Amador V, Esquivel-Pedraza L, Sierra-Madero J, Anaya- Saavedra G, Gonzalez-Ramirez I, Ponce-de-Leon S. The changing clinical spectrum of human immunodeficiency virus (HIV)-related oral lesions in 1,000 consecutive patients: a 12-year study in a referral center in Mexico. Medicine (Baltimore) 2003;82:39-50. https://doi.org/10.1097/00005792-200301000-00004
  12. Berberi A, Noujeim Z. Epidemiology and relationships between CD4+ counts and oral lesions among 50 patients infected with human immunodeficiency virus. J Int Oral Health 2015;7:18-21.
  13. Park YJ, Nam JH, Noh KL, Pang EO, Kim DY, Kim JH, et al. Aids-associated kaposi1s sarcoma on left lower retromolar triangle and parapharyngeal area: a case report. J Korean Oral Maxillofac Surg 2009;35:182-6.
  14. Vigneswaran N, Williams MD. Epidemiologic trends in head and neck cancer and aids in diagnosis. Oral Maxillofac Surg Clin North Am 2014;26:123-41. https://doi.org/10.1016/j.coms.2014.01.001
  15. Bunn BK, van Heerden WF. HIV/AIDS associated malignancies of the head and neck. SADJ 2012;67:590-2.
  16. Pakfetrat A, Falaki F, Delavarian Z, Dalirsani Z, Sanatkhani M, Zabihi Marani M. Oral manifestations of human immunodeficiency virus-infected patients. Iran J Otorhinolaryngol 2015;27:43-54.
  17. Bravo IM, Correnti M, Escalona L, Perrone M, Brito A, Tovar V, et al. Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population. Med Oral Patol Oral Cir Bucal 2006;11:E33-9.
  18. Bodhade AS, Ganvir SM, Hazarey VK. Oral manifestations of HIV infection and their correlation with CD4 count. J Oral Sci 2011;53:203-11. https://doi.org/10.2334/josnusd.53.203
  19. Fanales-Belasio E, Raimondo M, Suligoi B, Butto S. HIV virology and pathogenetic mechanisms of infection: a brief overview. Ann Ist Super Sanita 2010;46:5-14.
  20. Onakewhor JU, Olagbuji BN, Ande AB, Ezeanochie MC, Olokor OE, Okonofua FE. HIV-AIDS related maternal mortality in Benin City, Nigeria. Ghana Med J 2011;45:54-9.
  21. Taiwo OO, Hassan Z. The impact of Highly Active Antiretroviral Therapy (HAART) on the clinical features of HIV-related oral lesions in Nigeria. AIDS Res Ther 2010;7:19. https://doi.org/10.1186/1742-6405-7-19
  22. Zhou H, Zhao H, Hao Y, Song C, Han J, Zhang J, et al. Excessive conversion and impaired thymic output contribute to disturbed regulatory T-cell homeostasis in AIDS patients with low CD4 cell counts. AIDS 2013;27:1059-69. https://doi.org/10.1097/QAD.0b013e32835e2b99
  23. Serrano-Villar S, Sainz T, Lee SA, Hunt PW, Sinclair E, Shacklett BL, et al. HIV-infected individuals with low CD4/CD8 ratio despite effective antiretroviral therapy exhibit altered T cell subsets, heightened CD8+ T cell activation, and increased risk of non-AIDS morbidity and mortality. PLoS Pathog 2014;10:e1004078. https://doi.org/10.1371/journal.ppat.1004078
  24. Margolick JB, Gange SJ, Detels R, O'Gorman MR, Rinaldo CR Jr, Lai S. Impact of inversion of the CD4/CD8 ratio on the natural history of HIV-1 infection. J Acquir Immune Defic Syndr 2006;42:620-6. https://doi.org/10.1097/01.qai.0000223028.55080.9d
  25. Mocroft A, Bannister WP, Kirk O, Kowalska JD, Reiss P, D'Arminio-Monforte A, et al. The clinical benefits of antiretroviral therapy in severely immunocompromised HIV-1-infected patients with and without complete viral suppression. Antivir Ther 2012;17:1291-300. https://doi.org/10.3851/IMP2407
  26. Frimpong P, Amponsah EK, Abebrese J, Kim SM. Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana. J Korean Assoc Oral Maxillofac Surg 2017;43:29-36. https://doi.org/10.5125/jkaoms.2017.43.1.29
  27. Adurogbangba MI, Aderinokun GA, Odaibo GN, Olaleye OD, Lawoyin TO. Oro-facial lesions and CD4 counts associated with HIV/AIDS in an adult population in Oyo State, Nigeria. Oral Dis 2004;10:319-26. https://doi.org/10.1111/j.1601-0825.2004.01036.x
  28. Thompson GR 3rd, Patel PK, Kirkpatrick WR, Westbrook SD, Berg D, Erlandsen J, et al. Oropharyngeal candidiasis in the era of antiretroviral therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:488-95. https://doi.org/10.1016/j.tripleo.2009.11.026
  29. Castro LA, Alvarez MI, Martinez E. Pseudomembranous candidiasis in HIV/AIDS patients in Cali, Colombia. Mycopathologia 2013;175:91-8. https://doi.org/10.1007/s11046-012-9593-0
  30. Lin JN, Lin CC, Lai CH, Yang YL, Chen HT, Weng HC, et al. Predisposing factors for oropharyngeal colonization of yeasts in human immunodeficiency virus-infected patients: a prospective cross-sectional study. J Microbiol Immunol Infect 2013;46:129-35. https://doi.org/10.1016/j.jmii.2012.07.009

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