Manifestações estomatológicas, contagem de linfócitos T-CD4+ e carga viral de crianças brasileiras e norte-americanas infectadas pelo HIV

Abstract

A prevalência de manifestações estomatológicas associadas à infecção pelo HIV foi avaliada em 184 crianças de ambos os sexos, da faixa etária de zero a 13 anos de idade, atendidas nos Ambulatórios de AIDS Pediátrica do Hospital São Lucas (HSL) da PUCRS, e do Hospital de Clínicas de Porto Alegre (HCPA) da UFRGS, ambos em Porto Alegre, RS, Brasil e no Centro Pediátrico para Doenças Infecciosas do Hospital Universitário e Departamento de Odontopediatria da Faculdade de Odontologia da Universidade Estadual de Nova Iorque (SUNY) em Stony Brook, Nova Iorque, EUA, no período de janeiro de 1999 a maio de 2000. A freqüência de crianças brasileiras (72,73%) e norte-americanas (53,66%) com manifestações estomatológicas associadas à infecção pelo HIV foi estatisticamente significativa, com destaque para linfadenopatia cérvico-facial, aumento de volume das parótidas, candidíase eritematosa, petéquias, gengivite, xerostomia e queilite angular. As crianças com manifestações estomatológicas apresentaram contagens médias de linfócitos T-CD4+ próximas à normalidade e carga viral alta.

Prevalence of oral hairy leukoplakia in 120 pediatric patients infected with HIV-1

“…In the first reported cases of OHL, the diagnosis was based on the clinical appearence of the lesion associated with no response to antifungical treatment, thus ruling out oral candidiasis (OC) 8,13 . Nevertheless, several oral lesions may resemble OHL, including frictional kyperkeratosis, lichen planus, hyperplastic candidiasis, white sponge nevus and severe leukoedema 14 .…”

“…Other hypotheses that have also been raised in the attempt to explain the low prevalence of OHL in children are: OHL may appear only transiently, secondary to intermittent changes in CD4 cell numbers 9 ; children are not exposed to the innumerable strains of EBV that are necessary to produce the lesion 9,19 ; OHL would be a more delayed symptom of HIV infection appearing in older children 4,23 . The clinical significance and the prognostic implications of OHL in HIV-infected children are not yet well studied 13 . Many papers show the relationship between AIDS oral manifestations and CD4 cell counts and viral load in adults 2,3,6,16,23 .…”

“…Data such as age, route of HIV transmission, signs and symptoms, oral diseases, viral load, CD4 count, CD8 count and type of antiretroviral therapy were collected. Viral load was stratified in two groups: high (greater than 4.0 log 10 ) and low (lower than 4.0 log 10 ) according to Grando et al 13 (2002) study. Oral examinations were performed in all 120 patients under artificial light.…”

“…Moreover, it may be of prognostic value 4 . However, according to many authors, OHL has rarely been described in the HIV + pediatric population, with a prevalence varying from 0 to 6% 1,2,4,5,9,10,12,13,15,16,18,19,21 . The aim of this study was to verify OHL prevalence in HIV children using cytopathology.…”

Prevalence of Candida yeasts in oral samples from children with AIDS and children exposed and not exposed to HIV served by SUS in the state of Bahia, Brazil

“…In Brazil, AIDS cases in pediatric patients were first reported in 1983. Since then, AIDS cases in children have increased considerably in Brazil andworldwide [4][5][6] . Most children acquire the virus from their mothers through vertical transmission, which compromises their immune system in the fullness of its growth 6 .…”