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Ramos Peña DE, Pillet S, Grupioni Lourenço A, Pozzetto B, Bourlet T, Motta ACF. Human immunodeficiency virus and oral microbiota: mutual influence on the establishment of a viral gingival reservoir in individuals under antiretroviral therapy. Front Cell Infect Microbiol 2024; 14:1364002. [PMID: 38660490 PMCID: PMC11039817 DOI: 10.3389/fcimb.2024.1364002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
The role of the oral microbiota in the overall health and in systemic diseases has gained more importance in the recent years, mainly due to the systemic effects that are mediated by the chronic inflammation caused by oral diseases, such as periodontitis, through the microbial communities of the mouth. The chronic infection by the human immunodeficiency virus (HIV) interacts at the tissue level (e.g. gut, genital tract, brain) to create reservoirs; the modulation of the gut microbiota by HIV infection is a good example of these interactions. The purpose of the present review is to assess the state of knowledge on the oral microbiota (microbiome, mycobiome and virome) of HIV-infected patients in comparison to that of HIV-negative individuals and to discuss the reciprocal influence of HIV infection and oral microbiota in patients with periodontitis on the potential establishment of a viral gingival reservoir. The influence of different clinical and biological parameters are reviewed including age, immune and viral status, potent antiretroviral therapies, smoking, infection of the airway and viral coinfections, all factors that can modulate the oral microbiota during HIV infection. The analysis of the literature proposed in this review indicates that the comparisons of the available studies are difficult due to their great heterogeneity. However, some important findings emerge: (i) the oral microbiota is less influenced than that of the gut during HIV infection, although some recurrent changes in the microbiome are identified in many studies; (ii) severe immunosuppression is correlated with altered microbiota and potent antiretroviral therapies correct partially these modifications; (iii) periodontitis constitutes a major factor of dysbiosis, which is exacerbated in HIV-infected patients; its pathogenesis can be described as a reciprocal reinforcement of the two conditions, where the local dysbiosis present in the periodontal pocket leads to inflammation, bacterial translocation and destruction of the supporting tissues, which in turn enhances an inflammatory environment that perpetuates the periodontitis cycle. With the objective of curing viral reservoirs of HIV-infected patients in the future years, it appears important to develop further researches aimed at defining whether the inflamed gingiva can serve of viral reservoir in HIV-infected patients with periodontitis.
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Affiliation(s)
- Diana Estefania Ramos Peña
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
- Team Mucosal Immunity and Pathogen Agents (GIMAP), Centre International de Recherche en Infectiologie (CIRI), Institut national de la santé et de la recherche médicale (INSERM) U1111, Ecole Nationale Supérieure de Lyon, Université de Lyon, Université de Saint-Etienne, Saint-Etienne, France
| | - Sylvie Pillet
- Team Mucosal Immunity and Pathogen Agents (GIMAP), Centre International de Recherche en Infectiologie (CIRI), Institut national de la santé et de la recherche médicale (INSERM) U1111, Ecole Nationale Supérieure de Lyon, Université de Lyon, Université de Saint-Etienne, Saint-Etienne, France
- Department of Infectious Agents and Hygiene, University-Hospital of Saint-Etienne, Saint-Etienne, France
| | - Alan Grupioni Lourenço
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Bruno Pozzetto
- Team Mucosal Immunity and Pathogen Agents (GIMAP), Centre International de Recherche en Infectiologie (CIRI), Institut national de la santé et de la recherche médicale (INSERM) U1111, Ecole Nationale Supérieure de Lyon, Université de Lyon, Université de Saint-Etienne, Saint-Etienne, France
- Department of Infectious Agents and Hygiene, University-Hospital of Saint-Etienne, Saint-Etienne, France
| | - Thomas Bourlet
- Team Mucosal Immunity and Pathogen Agents (GIMAP), Centre International de Recherche en Infectiologie (CIRI), Institut national de la santé et de la recherche médicale (INSERM) U1111, Ecole Nationale Supérieure de Lyon, Université de Lyon, Université de Saint-Etienne, Saint-Etienne, France
- Department of Infectious Agents and Hygiene, University-Hospital of Saint-Etienne, Saint-Etienne, France
| | - Ana Carolina Fragoso Motta
- Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
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Pereira LMS, Dos Santos França E, Costa IB, Lima IT, Freire ABC, de Paula Ramos FL, Monteiro TAF, Macedo O, Sousa RCM, Freitas FB, Costa IB, Vallinoto ACR. Epidemiological risk factors associated with primary infection by Epstein-Barr virus in HIV-1-positive subjects in the Brazilian Amazon region. Sci Rep 2021; 11:18476. [PMID: 34531433 PMCID: PMC8446016 DOI: 10.1038/s41598-021-97707-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.
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Affiliation(s)
| | - Eliane Dos Santos França
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | - Iran Barros Costa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | - Igor Tenório Lima
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | | | | | | | - Olinda Macedo
- Laboratory of Retroviruses, Evandro Chagas Institute, Virology Section, Ananindeua, Pará, Brazil
| | - Rita Catarina Medeiros Sousa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil.,School of Medicine, Federal University of Pará, Belém, Pará, Brazil
| | - Felipe Bonfim Freitas
- Laboratory of Retroviruses, Evandro Chagas Institute, Virology Section, Ananindeua, Pará, Brazil
| | - Igor Brasil Costa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil. .,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil.
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Ren L, Wang B, Miao Z, Liu P, Zhou S, Feng Y, Yang S, Xia X, Wang K. A correlation analysis of HHV infection and its predictive factors in an HIV-seropositive population in Yunnan, China. J Med Virol 2019; 92:295-301. [PMID: 31621089 PMCID: PMC7004189 DOI: 10.1002/jmv.25609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/15/2019] [Indexed: 01/08/2023]
Abstract
Human herpesviruses (HHVs) have a particularly high prevalence in certain high‐risk populations and cause increased morbidity and mortality in patients with acquired immunodeficiency syndrome (AIDS). Screening and treating subclinical HHV infections reduce human immunodeficiency virus (HIV) infection incidence, disease progression, and transmission. However, there are few studies on HHVs, HIV coinfection rates, and their related risk factors. We aimed to clarify the prevalence of all eight HHVs in peripheral blood samples collected from HIV‐positive patients, and explore the association of HHV infection in HIV‐positive patients in an HIV‐seropositive population in Yunnan. We recruited 121 HIV‐positive patients with highly active antiretroviral therapy (HAART) and 45 healthy individuals. All the eight HHVs were detected using polymerase chain reaction and their epidemiological information and clinical data were collected and statistically analyzed. A high prevalence of HHVs (89.3%) was observed in individuals with HIV infections and with herpes simplex virus (HSV)‐2 (65.3%), and HSV‐1 (59.5%) being the most common. Coinfection with more than two different HHVs was more common in patients with HIV infections receiving HAART (72.7%) than in healthy controls. Older age, being married, higher HIV‐1 plasma viral loads, and use of antiviral protease inhibitors were independently correlated with an increased frequency of HHVs, but we found no association with CD4 count, WHO HIV clinical stage, and HIV infection duration. Our findings are of great significance for the prevention of HHV opportunistic infection in patients with AIDS and their clinical treatment. HHV co‐infection in AIDS patients deserves attention during the course of antiviral therapy. Suppressing HHV recurrences had a clinically significant effect on prolonging survival in some cohorts of HIV‐infected patients and may be an effective intervention in reducing HIV spread in China.
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Affiliation(s)
- Li Ren
- Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.,Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Binghui Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Zhijiang Miao
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Pan Liu
- Department of Urology, Yan'an Hospital of Kunming Chenggong Hospital, Kunming, China
| | - Shiyi Zhou
- Department of Gastrointestinal Surgery, Kunming Engineering Technology Center of Diagnosis and Treatment of Digestive Diseases, Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yun Feng
- Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, Kunming, China
| | - Shuting Yang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Kunhua Wang
- Department of Gastrointestinal Surgery, Kunming Engineering Technology Center of Diagnosis and Treatment of Digestive Diseases, Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Caliento R, Sarmento DJDS, Silva ÉMP, Tozetto-Mendoza TR, Tobouti PL, Benini V, Braz-Silva PH, Gallottini M. Oral shedding of HSV-1 and EBV and oral manifestations in paediatric chronic kidney disease patients and renal transplant recipients. Acta Odontol Scand 2018; 76:539-544. [PMID: 29409366 DOI: 10.1080/00016357.2018.1437218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Previous research demonstrated that salivary shedding of HSV-1 and EBV occurs often in adult renal transplant recipients, but there is a lack of studies on the presence of them in the saliva of paediatric population. Therefore, the objective of this study is to describe oral characteristics and to compare the shedding profile of HSV-1 and EBV in the saliva of children with renal transplant to that of chronic kidney disease patients and controls. METHODS This is a cross-sectional study involving 100 children, being 25 renal transplant recipients, 25 chronic kidney disease patients and 50 healthy children. Demographic and oral clinical characteristics were assessed. Saliva samples were collected and submitted to screening for EBV and HSV-1 by using nested polymerase chain reaction technique. Fisher's exact, Pearson's chi-square and Kruskal-Wallis tests were used for statistical analysis at a significance level of 5%. RESULTS Oral shedding of HSV-1 (28%) and EBV (60%) were significantly higher in renal transplant recipients compared to the other groups. Single vesicles in the oral mucosa were statistically associated with the presence of HSV-1 (p = .035). In children with chronic kidney disease, there was a higher prevalence of pale oral mucosa (32%) and enamel hypoplasia (40%) compared to paediatric renal transplant recipients and controls. Dental calculus (36%), candidiasis (8%), drug-induced gingival overgrowth (16%), mouth blisters (8%), xerostomia (12%) and salivary gland enlargement (20%) were more common in paediatric renal transplant recipients. CONCLUSIONS Therefore, it can be concluded that salivary shedding of HSV-1 and EBV in paediatric patients was more often found in renal transplant recipients than in the renal failure and control children. Transplanted recipients showed more oral manifestations than renal failure and control children did.
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Affiliation(s)
- Rubens Caliento
- Department of Stomatology, Division of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Priscila Lie Tobouti
- Department of Stomatology, Division of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vanda Benini
- Department of Nephrology, School of Medicine, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Paulo Henrique Braz-Silva
- Laboratory of Virology, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
- Department of Stomatology, Division of General Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marina Gallottini
- Department of Stomatology, Division of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Mainville GN, Marsh WL, Allen CM. Oral ulceration associated with concurrent herpes simplex virus, cytomegalovirus, and Epstein-Barr virus infection in an immunocompromised patient. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:e306-14. [PMID: 25544404 DOI: 10.1016/j.oooo.2014.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 10/18/2014] [Accepted: 10/28/2014] [Indexed: 12/01/2022]
Abstract
In immunocompromised patients, oral ulcerations are common and have a wide spectrum of causes, including herpesvirus infection. We report on a case in which an oral ulcer was simultaneously infected by herpes simplex (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) in a kidney-pancreas transplant recipient. A 46-year-old woman presented with a clinically nonspecific dorsal tongue ulcer of 3 months duration. Histopathologic evaluation indicated keratinocytes exhibiting herpetic viral cytopathic effect. Nuclear and cytologic alterations suggestive of CMV infection were found in endothelial cells subjacent to the ulcer. Immunohistochemistry testing for HSV and CMV was positive in these cells. Large atypical mononuclear cells were also evident in the ulcer bed's inflammatory infiltrate, which had intense nuclear positivity for Epstein-Barr encoding region in situ hybridization. We believe this is the first well-documented report of the definitive concomitant presence of HSV, CMV, and EBV in an immunocompromised patient. Although the pathogenesis of coinfected ulcers remains unknown, a synergistic effect is possible.
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Affiliation(s)
- Gisele N Mainville
- Assistant Professor, Department of Stomatology, Faculté de Médicine Dentaire, Université de Montréal, Montreal, Quebec, Canada.
| | - William L Marsh
- Professor, Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Carl M Allen
- Emeritus Professor, Division of Oral and Maxillofacial Pathology and Radiology, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Pinheiro RDS, Ferreira DDC, Nóbrega F, Santos NSDO, Souza IPRD, Castro GFBDA. Current status of herpesvirus identification in the oral cavity of HIV-infected children. Rev Soc Bras Med Trop 2013; 46:15-9. [PMID: 23563819 DOI: 10.1590/0037-868217172013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 12/13/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Some viruses of the Herpesviridae family are frequently the etiologic agents of oral lesions associated with HIV. The aim of this study was to identify the presence of herpes simplex virus types 1 and 2 (HSV-1, HSV-2), Varicella Zoster virus (VZV), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus type 6, type 7 and type 8 (HHV-6, HHV-7 and HHV-8) in the oral cavity of HIV-infected children/adolescents and verify the association between viral subtypes and clinical factors. METHODS The cells of oral mucosa were collected from 50 HIV infected children/adolescents, 3-13 years old (mean age 8.66). The majority (66%) of selected were girls, and they were all outpatients at the pediatric AIDS clinic of a public hospital in Rio de Janeiro. Nested-PCR was used to identify the viral types. RESULTS Absence of immunosuppression was observed in 66% of the children. Highly active antiretroviral therapy (HAART) was used by 72.1% of selected and moderate viral load was observed in 56% of the children/adolescents. Viral types were found in 86% of the children and the subtypes were: HSV-1 (4%), HSV-2 (2%), VZV (4%), EBV (0%), HCMV (24%), HHV6 (18%), HHV-7 (68%), HHV8 (0%). CONCLUSIONS The use of HAART has helped to reduce oral lesions, especially with herpes virus infections. The health professionals who work with these patients should be aware of such lesions because of their predictive value and the herpes virus can be found circulating in the oral cavity without causing lesions.
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Abstract
This article is a review of the literature between 2003 (since the last workshop) and April 2009 (Beijing workshop). It focuses on the prevalence of oral lesions associated with HIV infection, oral lesions as predictors of HIV infection, oral lesions as markers of the efficacy of highly active antiretroviral treatment and quality of life, caries risk, the management of oral lesions, and epidemiologic tests for clinical significance of oral lesions.
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Affiliation(s)
| | | | - M. Coogan
- Division of Oral Microbiology, University of Witswatersrand, Johannesburg, South Africa
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Carvalho KSS, Silvestre EDA, Maciel SDS, Lira HIG, Galvão RADS, Soares MJDS, Costa CHN, Malaquias LCC, Coelho LFL. PCR detection of multiple human herpesvirus DNA in saliva from HIV-infected individuals in Teresina, State of Piauí, Brazil. Rev Soc Bras Med Trop 2010; 43:620-3. [DOI: 10.1590/s0037-86822010000600003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Accepted: 09/16/2010] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Human herpesviruses are frequently associated with orofacial diseases in humans (HSV-1, EBV, CMV and HHV-8), some can also cause systemic disease (CMV and HHV-8). The transmission of these viruses occurs by contact with infected secretions, especially saliva. Human immunodeficiency virus infection is associated with an increased risk of HHVs and related diseases. METHODS: This work aimed to detect HSV-1, EBV, CMV and HHV-8 DNA in saliva of HIV-infected patients from Teresina, northeast Brazil, by PCR and compare these findings with age and sex matched HIV-seronegative individuals. RESULTS: No difference in prevalence was verified between HHV detection in the saliva of HIV-seropositive individuals and controls. The individual frequencies of these viruses in these two populations were different. HIV seropositivity correlated positively with the presence of CMV (OR: 18.2, p= 0.00032) and EBV (OR: 3.44, p= 0.0081). No association between CD4 counts and the prevalence of HHVs in the saliva was observed; however, a strong association was determined between seropositivity and the presence of multiple HHV DNAs in saliva (OR: 4.83, p = 0.0028). CONCLUSIONS: These findings suggest the asymptomatic salivary shedding of HHVs is a common event between HIV-seropositive and seronegative individuals from Teresina, Piauí, Brazil, and, especially for HIV-seropositive patients, saliva is a risk factor for the acquisition/transmission of multiple HHVs.
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Sero-prevalence of viral co-infections in HIV infected children of Northern India. Indian J Pediatr 2009; 76:917-9. [PMID: 19475358 DOI: 10.1007/s12098-009-0142-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2008] [Accepted: 08/07/2008] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the prevalence of viral co-infections in HIV infected children. METHODS Children born to HIV seropositive parents and those children who were suspected to be HIV infected based on clinical presentation by the pediatrician were screened for HIV -1 and 2 antibodies as per National Aids Control Organization (NACO) guidelines. Those found to be seropositive for HIV infection were further tested for Hepatitis B&C, Herpes simplex virus and Human cytomegalovirus infection. RESULTS Among 803 children screened, 101 were found positive for HIV antibodies. Among the five viral markers tested, HCMV IgG was positive in 88 children (87.1%). HCMV IgM was positive in 35 cases (34.6%). HBsAg tested positive in 30 children, while anti-HCV IgM was reactive in 27 cases. IgM anti- HSV antibodies were observed positive in 59 (58.4%) cases. Both hepatitis virus coinfection (HBsAg and anti- HCV IgM antibodies) was observed in 10 HIV positive children, while both Herpesviridae family viruses (HCMV -IgM antibodies and HSV -IgM antibodies) were positive in 30 cases (29.7%). CONCLUSION Viral co-infections are significantly higher in HIV positive children, which adds to significant mortality and morbidity and should therefore be screened in all HIV positive children for timely treatment in order to improve the quality of life and better survival of HIV infected children.
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dos Santos Pinheiro R, França TT, Ribeiro CMB, Leão JC, de Souza IPR, Castro GF. Oral manifestations in human immunodeficiency virus infected children in highly active antiretroviral therapy era. J Oral Pathol Med 2009; 38:613-22. [DOI: 10.1111/j.1600-0714.2009.00789.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Digestive, hepatic, and nutritional manifestations in Latin American children with HIV/AIDS. J Pediatr Gastroenterol Nutr 2008; 47 Suppl 1:S24-6. [PMID: 18667913 DOI: 10.1097/mpg.0b013e3181818f69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The HIV/AIDS infection is increasing in Latin America and the Caribbean regions, according to the World Health Organization (WHO). In Latin America, most cases are in Brasil, Mexico, and Colombia. Some causes of the HIV/AIDS infection in Latin America are poverty, limitations on the access to antiretroviral drugs, poor response from governmental and health authorities, migration, and scantiness of research resources. In the pediatric population, perinatal transmission is the main contact mechanism. Several digestive, hepatic, and nutritional manifestations allow the classification of HIV infection in children, according to the Centers for Disease Control and Prevention. Improvement in knowledge of the epidemiology, pathogenesis, physiopathology; and management of HIV enteropathy and on nutritional care practices of infected HIV children is recommended.
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