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Karajacob AS, Al-Maleki AR, Tay ST. Revisiting oral thrush in South-East Asian patients: A review of published studies (2000-2020). J Oral Pathol Med 2021; 51:98-105. [PMID: 34859509 DOI: 10.1111/jop.13266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/03/2021] [Accepted: 11/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oral thrush, a clinical condition due to an overgrowth of Candida yeasts in the oral cavity, is prominent in patients with immunosuppression. As recent updates on oral thrush in South-East Asian (SEA) countries are lacking, this review aimed to address the epidemiology, clinical features and distribution of Candida species, based on published studies in SEA countries over the last two decades. METHODS Published studies on oral candidiasis (2000-2020) were retrieved from PubMed, Scopus, ISI Web of Science and Google Scholar databases to provide information on the incidence and factors affecting oral thrush cases in SEA countries. RESULTS A total of 22 cross-sectional studies involving 3697 subjects from five SEA countries were reviewed in this study. The most frequently reported population were human immunodeficiency virus (HIV)-infected patients. The overall incidence rates amongst HIV-infected patients ranged from 20.7% to 97.0%, while incidence rates ranging from 0% to 72.7% were recorded for non-HIV-infected populations. Pseudomembranous candidiasis and erythematous candidiasis were the most common clinical presentations of oral thrush lesions. Candida albicans was the most common species identified in SEA studies. As oral thrush assessments were made merely based on clinical diagnosis, culture results were not available for most studies. CONCLUSION This review highlights that most studies reporting on oral candidiasis in SEA countries were based on HIV-positive patients. Data are still lacking on oral candidiasis amongst non-HIV immunocompromised and immunocompetent patients. Increasing awareness on the diagnosis, treatment and consequences of this infection, and improved laboratory methods are essential for the management of oral candidiasis in this region.
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Affiliation(s)
| | - Anis Rageh Al-Maleki
- Faculty of Medicine, Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia
| | - Sun Tee Tay
- Faculty of Medicine, Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia
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Peña DER, Innocentini LMAR, Saraiva MCP, Lourenço AG, Motta ACF. Oral candidiasis prevalence in human immunodeficiency virus-1 and pulmonary tuberculosis coinfection: A systematic review and meta-analysis. Microb Pathog 2021; 150:104720. [PMID: 33412246 DOI: 10.1016/j.micpath.2020.104720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Human immunodeficiency virus-1 (HIV-1) infected people are more likely to develop tuberculosis (TB), being the leading cause of death in HIV-1. Candida spp has emerged as potential pathogenic fungi in patients with HIV and bronchopulmonary diseases. This systematic review summarizes the available data on the occurrence of oral candidiasis (OC) in the HIV-1/pulmonary tuberculosis (pTB) coinfection. METHODS Articles that reported the occurrence of OC in the HIV-1-pTB coinfection were searched in eight databases. Observational studies that evaluated the association between OC and HIV-1-pTB coinfection were selected. The risk of bias was assessed using the meta-analysis of statistics assessment and review instrument (MAStARI) checklist. RESULTS From a total of 1858 records, after application of inclusion and exclusion criteria, six were included in the meta-analysis. Three studies were at low risk, one at moderate risk, and two at high risk of bias. Considerable heterogeneity across the studies was identified. Meta-analyses performed showed no difference in the prevalence of OC between HIV-1 patients with and without pTB coinfection (odds ratio M-H = 1.77; 95% CI = 0.69 to 4.52). CONCLUSION There is no association between OC and HIV-1/pTB coinfection. PROSPERO REGISTRATION NUMBER CRD42019128735.
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Affiliation(s)
- Diana Estefania Ramos Peña
- Department of Oral & Maxillofacial Surgery, and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Lara Maria Alencar Ramos Innocentini
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil; Division of Dentistry and Stomatology of the Clinical Hospital of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Maria Conceição Pereira Saraiva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Alan Grupioni Lourenço
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Ana Carolina Fragoso Motta
- Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
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Gannepalli A, Krishna AB, Baghirath PV, Vinay BH, Khaled S, Anjum B. Oral Manifestations in HIV-TB Co- infected Patients and Their Correlation with CD4 Count in Telangana State, India. J Int Soc Prev Community Dent 2020; 10:21-35. [PMID: 32181218 PMCID: PMC7055335 DOI: 10.4103/jispcd.jispcd_448_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 10/29/2019] [Indexed: 11/05/2022] Open
Abstract
AIMS AND OBJECTIVES Human immunodeficiency virus (HIV)-related oral lesions are often an early finding, and they reflect the underlying immunosuppression, and tuberculosis (TB) coinfection can have further deteriorating effect. Hence, a cross-sectional study was conducted to evaluate clinical and oral presentations of patients coinfected with HIV-TB, correlating with various parameters such as the type of TB with CD4 cell count, the type of TB with oral manifestations, site of the lesion, oral manifestations with CD4 cell counts, age, and gender. MATERIALS AND METHODS A cross-sectional study was conducted among selected 200 patients coinfected with HIV-TB, registered at Gandhi Medical College, Hyderabad, Telangana, India, and demographic data, CD4 count, diagnosis of TB, and clinical presentation of TB were correlated with site, age, gender, and the type of lesions in the oral cavity. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, (IBM SPSS), version 20 (Chicago, IL, USA), with the chi-square test, and the significant P value for all the parameters was considered as <0.05. RESULTS A total of 200 patients with HIV-TB coinfection, who presented with oral lesions of 258 coinfected cases, were examined. Among which, 129 patients were with pulmonary tuberculosis (PTB), 61 patients with extrapulmonary TB, 2 patients with disseminated TB, and 8 patients with PTB and pneumonia. There were multiple oral manifestations involving different sites of oral cavity, oral candidiasis (28.5%), angular cheilitis (24.5%), linear gingival erythema (21.5%), oral hairy leukoplakia (1.5%), melanotic pigmentation (29.0%), ulcers (20.0%), depapillation of tongue (26.5%), lobulated tongue (12.0%), hairy tongue (11.5%), and papules (10.0%). The correlation of the type of TB with CD4 cell count, oral lesions with the type of TB in tongue, labial mucosa, and palate was significant. CONCLUSION A total of 77.5% patients coinfected with HIV-TB had shown oral manifestations emphasizing that the presence of oral lesions can be considered as a strong indicator of coinfection. The oral lesions might be used as a clinical indicator or screening mechanism in patients who were HIV seropositive for TB coinfection and should be necessarily evaluated for TB.
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Affiliation(s)
- Ashalata Gannepalli
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India
| | - Ayinampudi B. Krishna
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India
| | - Pacha V. Baghirath
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India
| | - Balistty Hari Vinay
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India
| | - Sana Khaled
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India
| | - Bushra Anjum
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India
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El Howati A, Tappuni A. Systematic review of the changing pattern of the oral manifestations of HIV. ACTA ACUST UNITED AC 2018; 9:e12351. [PMID: 30019446 DOI: 10.1111/jicd.12351] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/20/2018] [Indexed: 11/27/2022]
Abstract
The purpose of the present study paper was to review the reported prevalence of the oral manifestations of HIV (OM-HIV) worldwide since 1980, and to determine the global variation in its prevalence over time. PubMed, Scopus, Embase and Google Scholar were searched. The filter "English" was used. The timeframe searched was 1980- 2015. The PRISMA flow chart was used. Data were extracted using the Joanna Briggs Institute standardized data extraction form and transferred to SPSS version 22 for analysis. The systematic review of 97 studies (70 low bias risk) showed that the prevalence of OM-HIV continue to be significant in developing countries. Globally and through all the decades, oral candidiasis remained the most commonly encountered OM-HIV, including among patients on antiretroviral therapy (ART) (26.2%). Hairy leukoplakia was more prevalent in Europe and America compared with Africa and Asia. Oral warts were reported more often in studies on patients receiving ART. Interestingly, salivary gland disease decreased in the developed world and increased in developing countries over time. Despite the changing pattern of these conditions over time, there is no evidence that the OM-HIV have become of less significance globally. Maintaining the drive for high-quality research in the subject will have an impact on less developed countries to help address oral health inequalities.
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Affiliation(s)
- Asma El Howati
- Department of Oral Medicine, Institute of Dentistry, Queen Mary University of London, London, UK.,Department of Oral Medicine, Faculty of Dentistry, Benghazi (Garyounis) University, Benghazi, Libya.,Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Libyan International Medical University, Benghazi, Libya
| | - Anwar Tappuni
- Department of Oral Medicine, Institute of Dentistry, Queen Mary University of London, London, UK
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Oral manifestations of HIV in children receiving anti-retroviral therapy in Hyderabad, India. Eur Arch Paediatr Dent 2013; 14:389-95. [DOI: 10.1007/s40368-013-0028-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 03/23/2013] [Indexed: 10/26/2022]
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Dongo M, Gonçalves LS, Ferreira SMS, Noce CW, Dias EP, Júnior AS. Gender differences in oral manifestations among HIV-infected Brazilian adults. Int Dent J 2013; 63:189-95. [PMID: 23879254 DOI: 10.1111/idj.12029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
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.
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Affiliation(s)
- Maria Dongo
- Medical School, Fluminense Federal University, Niteroi, Brazil
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Eweka OM, Agbelusi GA, Odukoya O. Prevalence of oral lesions and the effects of HAART in adult HIV patients attending a tertiary hospital in Lagos, Nigeria. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojst.2012.23036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bodhade AS, Ganvir SM, Hazarey VK. Oral manifestations of HIV infection and their correlation with CD4 count. J Oral Sci 2011; 53:203-11. [PMID: 21712625 DOI: 10.2334/josnusd.53.203] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Human Immunodeficiency Virus (HIV)-related oral lesions can be used as markers of the immune status. The present cross-sectional study was conducted to identify the oral manifestations in HIV-infected individuals and their association with reduced Cluster of Differentiation 4 (CD4) count. The study population included known HIV-positive patients. A detailed case history of 399 HIV-positive patients was obtained and general examination was carried out. Diagnosis of oral lesions was done based on presumptive criteria of EEC Clearinghouse, 1993. The CD4 count was determined in 369 patients and correlated with oral manifestations. The prevalence of oral lesions was found to be 76.70% (n = 306). Oral candidiasis (157 (39.3%)) was the most common oral lesion associated with HIV infection. Amongst various forms of oral candidiasis, erythematous candidiasis (122 (39.3%)) outnumbered the other forms. The mean CD4 count of patients with oral lesions (207 cells/mm(3)) was less than in patients without oral lesions (291 cells/mm(3)) (P = 0.002). Oral candidiasis was found to be significantly correlated to a reduced CD4 cell count below 200 cells/mm(3) (P = 0.000; Odds ratio = 3.1; 95% Confidence interval 1.9-4.9) with good sensitivity, best specificity and positive predictive value. Oral manifestations may be used as an alternative to CD4 count at field-based settings to diagnose the immune compromised status of HIV-infected individuals.
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Affiliation(s)
- Ashish S Bodhade
- Department of Oral and Maxillofacial Pathology, VSPM'S Dental College and Research Center, Nagpur, Maharashtra, India.
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Khatibi M, Moshari AA, Jahromi ZM, Ramezankhani A. Prevalence of oral mucosal lesions and related factors in 200 HIV+/AIDS Iranian patients. J Oral Pathol Med 2011; 40:659-64. [DOI: 10.1111/j.1600-0714.2011.01013.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Ranganathan K, Geethalakshmi E, Krishna Mohan Rao U, Vidya KM, Kumarasamy N, Solomon S. Orofacial and systemic manifestations in 212 paediatric HIV patients from Chennai, South India. Int J Paediatr Dent 2010; 20:276-82. [PMID: 20536589 DOI: 10.1111/j.1365-263x.2010.01050.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Kannan Ranganathan
- Department of Oral Pathology, Ragas Dental College and Hospital, Uthandi, Chennai, India.
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Mercedes Panizo M, Reviákina V, Navas T, Casanova K, Sáez A, Napoleón Guevara R, María Cáceres A, Vera R, Sucre C, Arbona E. Neumocistosis en pacientes venezolanos: diagnóstico y epidemiología (2001-2006). Rev Iberoam Micol 2008; 25:226-31. [DOI: 10.1016/s1130-1406(08)70054-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ranganathan K, Narasimhan P, Vidya KM, Gunaseelan R, Kumarasamy N, Solomon S, Samaranayake LP. Oral Candida species in healthy and HIV-infected subjects in Chennai, South India. Trop Med Health 2008. [DOI: 10.2149/tmh.2007-28] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Hamza OJM, Matee MIN, Simon ENM, Kikwilu E, Moshi MJ, Mugusi F, Mikx FHM, Verweij PE, van der Ven AJAM. Oral manifestations of HIV infection in children and adults receiving highly active anti-retroviral therapy [HAART] in Dar es Salaam, Tanzania. BMC Oral Health 2006; 6:12. [PMID: 16916469 PMCID: PMC1559688 DOI: 10.1186/1472-6831-6-12] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Accepted: 08/18/2006] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of the study was to compare the prevalence and types of HIV-related oral lesions between children and adult Tanzanian patients on HAART with those not on HAART and to relate the occurrence of the lesions with anti-HIV drug regimen, clinical stage of HIV disease and CD4+ cell count. METHODS Participants were 532 HIV infected patients, 51 children and 481 adults, 165 males and 367 females. Children were aged 2-17 years and adults 18 and 67 years. Participants were recruited consecutively at the Muhimbili National Hospital (MNH) HIV clinic from October 2004 to September 2005. Investigations included; interviews, physical examinations, HIV testing and enumeration of CD4+ T cells. RESULTS A total of 237 HIV-associated oral lesions were observed in 210 (39.5%) patients. Oral candidiasis was the commonest (23.5%), followed by mucosal hyperpigmentation (4.7%). There was a significant difference in the occurrence of oral candidiasis (chi2 = 4.31; df = 1; p = 0.03) and parotid enlargement (chi2 = 36.5; df = 1; p = 0.04) between children and adults. Adult patients who were on HAART had a significantly lower risk of; oral lesions (OR = 0.32; 95% CI = 0.22-0.47; p = 0.005), oral candidiasis (OR = 0.28; 95% CI = 0.18-0.44; p = 0.003) and oral hairy leukoplakia (OR = 0.18; 95% CI = 0.04-0.85; p = 0.03). There was no significant reduction in occurrence of oral lesions in children on HAART (OR = 0.35; 95% CI = 0.11-1.14; p = 0.15). There was also a significant association between the presence of oral lesions and CD4+ cell count < 200 cell/mm3 (chi2 = 52.4; df = 2; p = 0.006) and with WHO clinical stage (chi2 = 121; df = 3; p = 0.008). Oral lesions were also associated with tobacco smoking (chi2 = 8.17; df = 2; p = 0.04). CONCLUSION Adult patients receiving HAART had a significantly lower prevalence of oral lesions, particularly oral candidiasis and oral hairy leukoplakia. There was no significant change in occurrence of oral lesions in children receiving HAART. The occurrence of oral lesions, in both HAART and non-HAART patients, correlated with WHO clinical staging and CD4+ less than 200 cells/mm3.
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Affiliation(s)
- Omar JM Hamza
- Department of Oral Surgery and Oral Pathology, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
| | - Mecky IN Matee
- Department of Microbiology and Immunology, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
| | - Elison NM Simon
- Department of Oral Surgery and Oral Pathology, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
| | - Emil Kikwilu
- Department of Preventive and Community Dentistry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
| | - Mainen J Moshi
- Institute of Traditional Medicine, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
| | - Ferdinand Mugusi
- Department of Internal Medicine, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
| | - Frans HM Mikx
- WHO Collaborating Center, Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Paul E Verweij
- Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - André JAM van der Ven
- Department of General Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Tüzün Y, Kalayciyan A, Engin B, Tüzün B. Life-threatening disorders of mucous membranes. Clin Dermatol 2005; 23:267-75. [PMID: 15896542 DOI: 10.1016/j.clindermatol.2004.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Oral mucosa is one of the first barriers to the outside world which encounters various antigens, microorganisms and physical agents. Numerous oral pathologies challenge the dermatologists. Some may be the first sign of an underlying immunosuppression, while others are the inevitable serious outcomes of long-lasting mucosal disease. The differential diagnosis is crucial in terms of prompt and effective treatment.
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Affiliation(s)
- Yalçin Tüzün
- Department of Dermatology, Cerrahpasa Medical Faculty, Istanbul University, Aksaray, Turkey.
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Abstract
OBJECTIVE This study describes the involvement and the histological alterations found in the tongues of 92 autopsied patients who died with AIDS. MATERIALS AND METHODS Sex, age, CD4 cell count and clinical history were obtained from the files of 92 patients who died with AIDS. All the tongues were examined for macroscopical alterations and stained using H&E, Gomori-Grocott, Ziehl-Neelsen, PAS, Brow-Hopps and Mucicarmine. Histological autopsy findings were grouped based on a protocol that was designed following the World Health Organization recommendations. RESULTS The mean age of the patients who died of AIDS and CD4 cell count were 36 years and 82 cells microL(-1), respectively. Histological alterations of the tongues were found in 75% of the cadavers. The most common lesions were hairy leukoplakia (HL) (42 cases), candidosis (31 cases) and non-specific chronic glossitis (29 cases), followed by concomitant lesions (28 cases), non-specific chronic ulceration (17 cases), melanotic pigmentation (13 cases), herpes simplex (10 cases), lymphoepithelial cysts (two cases), cryptococcosis (two cases), mycobacteriosis (one case), histoplasmosis (one case), cytomegalovirus infection (one case) and non-Hodgkin Lymphoma (one case). HL with oral candidosis (n = 13) were the most common concomitant lesions. CONCLUSION These findings indicate that the tongue is a favorite site to occurrence of reactive, infectious and concurrent lesions in the end-stage of AIDS patients.
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Affiliation(s)
- P R de Faria
- Department of Oral Pathology, Dental School of Piracicaba-UNICAMP, Piracicaba-SP, Brazil
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Schmidt-Westhausen AM, Bendick C, Reichart PA, Samaranayake LP. Oral candidosis and associated Candida species in HIV-infected Cambodians exposed to antimycotics. Mycoses 2005; 47:435-41. [PMID: 15504130 DOI: 10.1111/j.1439-0507.2004.01019.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although human immundeficiency virus (HIV) infection is endemic in Southeast Asia, data on oral mycotic flora in this disease in Asians are sparse. The aim of this study was to determine the prevalence of Candida species in HIV-infected Cambodians with oral candidosis, unexposed (group 1) and exposed to antimycotics (group 2) and a healthy population (group 3). In 161 HIV patients with oral candidosis (group 1: 121 pts; group 2: 40 pts) and in 81 controls (group 3) swab samples of tongue and palate were obtained. Oral candidosis was detected in 100 and 70% of groups 1 and 2 respectively. Candida spp. were isolated from 91 and 100% of groups 1 and 2, respectively, and from 79% of controls. Candida albicans was the most common, with non-albicans species such as C. tropicalis and C. krusei being notable. Our data indicate that variants of oral candidal infections in HIV disease are similar to those seen in the pre-HAART era. The particularly high rate of C. krusei isolation in all groups is noteworthy.
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Affiliation(s)
- A M Schmidt-Westhausen
- Department of Oral Surgery and Dental Radiology, Charité, University Medicine Berlin, Berlin, Germany.
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Chattopadhyay A, Caplan DJ, Slade GD, Shugars DC, Tien HC, Patton LL. Risk indicators for oral candidiasis and oral hairy leukoplakia in HIV-infected adults. Community Dent Oral Epidemiol 2005; 33:35-44. [PMID: 15642045 DOI: 10.1111/j.1600-0528.2004.00194.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Oral candidiasis (OC) and oral hairy leukoplakia (OHL) are the most common oral mucosal diseases associated with HIV infection. Independent risk indicators associated with these sentinel opportunistic diseases have not been established in mixed race and gender adult populations in the southeast USA. The purposes of this study were 1) to estimate prevalence of OC and OHL among an HIV-1 positive adult population, and 2) to develop explanatory multivariable models for each disease outcome. METHODS This cross-sectional study evaluated 631 adult dentate HIV-1 seropositive persons examined for HIV-associated oral mucosal diseases between 1995 and 2000 at University of North Carolina Hospitals in Chapel Hill, North Carolina using data collected from medical record review, interview questionnaire and clinical examination. We analyzed the data using t-tests, anova, and unconditional logistic regression. RESULTS Prevalent OC was associated with low CD4+ cell count [<200 cells/microl, adj. OR = 12.7 (95%CI: 4.9-32.9)], antiretroviral combination therapy [OR = 0.6 (0.3-0.9)], and current smoking [OR = 2.5 (1.3-4.8)]. Prevalent OHL was associated with low CD4+ cell count [<200 cells/microl, OR = 7.2 (2.7-18.9)], antifungal medication use [OR = 1.8 (1.1-2.9)], current recreational drug use [OR = 2.5 (1.3-4.9)], and male gender [OR = 2.5 (1.3-4.8)]. CONCLUSIONS While CD4+ cell count, and antiretroviral medication were important risk indicators for OC, and OHL, cigarette smoking appears to be an important risk indicator for OC in HIV-1-infected populations.
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