ABSTRACT
The vast majority of children with HIV infection present oral manifestations among the first signs of illness. These lesions are not produced directly by the virus, but are manifestations associated with HIV infection, and are not pathognomic of the infection itself. Some of these oral lesions have a prognostic value with regard to progression of the infection and the appearance of AIDS; independently of other, more commonly used markers. The essential risk factors that influence the development of such oral manifestations are the low number of CD4+ lymphocytes, xerostomia, and the lack of anti-retroviral therapy. Opportunist infections, such as mycoses -- including pseudomembranous oral candidiasis, are found with higher frequency; followed by the herpetic viral infections. The oral lesions that appear in infected children differ in prevalence from those found in seropositive adults, some, such as parotid hypertrophy, present more exclusively in children, others, such as periodontal bacterial infections and Kaposi's Sarcoma, are lesions that predominate in the adult HIV-infected population. Given the current impact of the pandemic caused by HIV, it is the responsibility of dental professionals to prevent, detect, treat and control the oral lesions in those patients infected with HIV. All of which will be reflected in a reduction in transmission, lower mortality and greater long-term survival for infected children.
Subject(s)
HIV Infections/complications , Mouth Diseases/etiology , Humans , Infant , Mouth Diseases/microbiologyABSTRACT
La gran mayoría de niños con infección por VIH presentan, dentro de sus primeros signos de enfermedad, manifestaciones orales. Estas lesiones orales no están producidas directamente por dicho virus, son manifestaciones asociadas a la infección por VIH, ya que no son patognomónicas de la infección. Algunas de estas lesiones orales tienen un valor pronóstico de cara a la evolución de la infección y la aparición de SIDA, independientemente de otros marcadores de uso más común. Los factores de riesgo esenciales que predisponen al desarrollo de dichas manifestaciones orales son el bajo número de linfocitos T CD4+, xerostomía y la ausencia de tratamiento antiretroviral. Infecciones oportunistas como las micosis, entre ellas la candidiasis oral pseudomembranosa se hallan con mayor prevalencia; seguidas de las infecciones víricas herpéticas. Las lesiones orales que aparecen en niños infectados se difieren en cuanto a prevalencia a las halladas en el paciente adulto seropositivo, algunas como la hipetrofia parotídea se presentan con mayor exclusividad en niños, otras como las infecciones bacterianas periodontales, el Sarcoma de Kaposi son lesiones que predominan en población adulta infectada por VIH. Dada la trascendencia actual de la pandemia causada por VIH, es responsabilidad de los profesionales odontólogos y estomatólogos el prevenir, diagnosticar precozmente, tratar y controlar las lesiones orales de los pacientes infectados por el VIH. Todo ello refleja una reducción en la transmisión, menor mortalidad y mayor supervivencia a largo plazo de los niños infectados (AU)
The vast majority of children with HIV infection present oral manifestations among the first signs of illness. These lesions are not produced directly by the virus, but are manifestations associated with HIV infection, and are not pathognomic of the infection itself. Some of these oral lesions have a prognostic value with regard to progression of the infection and the appearance of AIDS; independently of other, more commonly used markers. The essential risk factors that influence the development of such oral manifestations are the low number of CD4+ lymphocytes, xerostomia, and the lack of anti-retroviral therapy. Opportunist infections, such as mycoses - including pseudomembranous oral candidiasis, are found with higher frequency; followed by the herpetic viral infections. The oral lesions that appear in infected children differ in prevalence from those found in seropositive adults, some, such as parotid hypertrophy, present more exclusively in children, others, such as periodontal bacterial infections and Kaposi's Sarcoma, are lesions that predominate in the adult HIV-infected population. Given the current impact of the pandemic caused by HIV, it is the responsibility of dental professionals to prevent, detect, treat and control the oral lesions in those patients infected with HIV. All of which will be reflected in a reduction in transmission, lower mortality and greater long-term survival for infected children (AU)
