Manifestaciones orales asociadas a la infección por el VIH/sida en la etapa de expansión de la terapéutica antirretroviral: una década en revisión (2000-2010) / Oral Manifestations Associated to HIV Infection under ART/HAART: Review of a Decade 2000-2010
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nov 4, 2015
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Objetivo: identificar los indicadores epidemiológicos de manifestaciones orales asociadas con la infección por virus de inmunodeficiencia humana (VIH) en la etapa de expansión terapéutica antirretroviral. Métodos: se revisó literatura en las bases bibliográficas disponibles en la Universidad Nacional de Colombia. Se utilizó un proceso de revisión con base en la evidencia. Cumplieron los criterios de inclusión 52 artículos publicados entre 2000 y 2010. Resultados: después de la introducción de tratamiento antirretroviral de gran actividad, los estudios proveen evidencia consistente en cuanto a: 1) menor prevalencia, gravedad o extensión de candidosis oral, leucoplasia vellosa y enfermedad periodontal asociada al VIH; 2) decremento global, aunque todavía prevalencia alta de sarcoma de Kaposi en África y Latinoamérica, quizás por desigual distribución geográfica del herpesvirus humano 8, y 3) incremento en verrugas orales y úlceras asociadas a los antirretrovirales. Conclusiones: este artículo de reflexión respalda el beneficio de la ampliación de los regímenes de antirretrovirales en todo el mundo y una importante reducción de las manifestaciones orales asociadas al VIH aunque un menor descenso en los países pobres. Los retos para la odontología están en identificar y tratar adecuadamente a las personas VIH+ especialmente en países con recursos limitados.
Objective: To identify epidemiological indicators of oral manifestations associated to HIV/AIDS. Methods: This is an evidence-based review of literature carried out using the bibliographic databases available at the National University of Colombia. Fifty two articles published between 2000 and 2010 met the inclusion criteria. Results: After the introduction of the high activity antiretroviral therapy (HAART), studies provide consistent evidence of: (1) lesser prevalence, severity, or extent of oral candidiasis, oral hairy leukoplakia and HIV-related periodontal disease; (2) global decrease but nevertheless high prevalence of Kaposi´s sarcoma in Africa and Latin America due to the unequal geographical distribution of human herpesvirus 8; and (3) increases in oral warts and antiretroviral-related (ARV) ulcers. Conclusions: The reports reviewed provide evidence of the benefits of scaling-up ART/HAART regimens worldwide and an important reduction of oral manifestations associated to HIV-infection (except oral warts and ARV-related ulcers), although in a lesser degree in the underdeveloped countries. Challenges lie in the role of oral health care workers in identifying patients who are HIV-positive and in effectively managing their oral and systemic conditions, particularly in resource-poor settings.
Keywords
References
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4. Onusida, República de Colombia, Ministerio de Salud. Infección por VIH y SIDA en Colombia: aspectos fundamentales, respuesta nacional y situación actual. Un balance histórico hacia el nuevo siglo. Bogotá: Onusida, Ministerio de Salud; 2001.
5. Estrada JH. Lesiones orales asociadas con la infección por VIH/Sida en individuos sin tratamiento antirretroviral en el Hospital San Juan de Dios de Bogotá. Biomédica. 2001; 21: 333-44.
6. Greenspan JS. Sentinels and signposts: the epidemiology and significance of the oral manifestations of HIV disease. Oral Dis. 1997; 3(Suppl I): S13-S17.
7. Greenspan JS, Barr CE, Sciubba JJ, Winkler JR. Oral manifestations of HIV infection. Definitions, diagnostic criteria and principles of therapy. Oral Surg Oral Med Oral Pathol 1992; 73: 142-4.
8. Greenspan D, Greenspan JS. Oral manifestations of human immunodeficiency virus infection. Dental Clinics North Am. 1993; 37: 21-32.
9. Glick M. The role of the dentist in the era of AIDS. Dent Clin North Am. 1996; 40: 343-57.
10. Greenspan D, Greenspan JS. Management of the oral lesions of HIV infection. J Am Dent Assoc. 1991; 122: 26-32.
11. Scully C, McCarthy G. Management of oral health in persons with HIV infection. Oral Surg Oral Med Oral Pathol. 1992; 73: 215-25.
12. American Dental Association. Dental treatment to the HIV infected patients. J Am Den Assoc; 1995; 126(Suppl 1): 39.
13. República de Colombia, Ministerio de Salud, Dirección General de Promoción y Prevención. Manual de aspectos básicos: infección por VIH/SIDA-hepatitis B. Medidas para el control de infecciones en Odontología. Bogotá: Ministerio de Salud; 1995. p. 42.
14. USPH/IDSA Prevention of Opportunistic Infections Working Group. 1999 USPH/IDSA guidelines for prevention of opportunistic infections in persons infected with human immunodeficiency virus. Clin Infect Dis. 2000; 30(Suppl 1): S29-S65.
15. Organización Panamericana de la Salud (OPS). Sistemas y servicios de salud: programa regional de salud bucodental. Estrategia regional de salud bucodental para los años noventa. Quito: OPS; 1994.
16. Reidpath D, Chan K. HIV, Stigma, and rates of infection: a rumour without evidence. PLoS Med. 2006; 3(10): 1708-10.
17. Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci & Med. 2003; 57: 13-24.
18. Pindborg JJ. Classification of oral lesions associated with HIV infection/AIDS. Oral Surg Oral Med Oral Pathol. 1989; 67: 292-5.
19. Scully C, Laskaris G, Pindborg J, Porter SR, Reichart P. Oral manifestations of HIV infection and their management. I. More common lesions. Oral Surg Oral Med Oral Pathol. 1991; 71: 158-66.
20. Scully C, Laskaris G, Pindborg J, Porter SR, Reichart P. Oral manifestations of HIV infection and their management. II. Less common lesions. Oral Surg Oral Med Oral Pathol. 1991; 71: 167-71.
21. Scully C, Bagg J. Viral infections in dentistry. Oral Maxillofac Surg Infect. 1992; 111: 102-15.
22. 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.
23. Porter S, Scully C. HIV: the surgeon’s perspective. Part 2. Diagnosis and management of non-malignant oral manifestations. Br J Oral Maxillofac Surg. 1994; 32: 231-40.
24. Greenspan D, Greenspan JS. HIV related disease. Lancet. 1996; 348: 729-33.
25. Casiglia J, Woo S. Oral manifestations of HIV infection. Clin Dermatol. 2000; 18: 541-51.
26. Plettenberg A, Reisinger E, Lenzner U, Listemann H, Ernest M, Kern P, Dietrich M, Meigel W. Oral candidosis in HIV infected patients: prognostic value and correlation with immunological parameters. Mycoses. 1990; 5: 610-8.
27. Nielsen H, Bentsen KD, Hojtved L, Willemoes EH, Scvheutz F, Schiødt M, Stoltze K, Pindborg JJ. Oral candidiasis and immune status of HIV infected patients. J Oral Pathol Med. 1997; 26: 237-43.
28. Estrada JH, Núñez GA, Rodríguez M, Díaz D. Atención al paciente con VIH. Guía de Práctica Clínica Basadas en la Evidencia. Bogotá: Asociación Colombiana de Facultades de Odontología, Instituto del Seguro Social; 1998.
29. Husak R, Garbe C, Orfanos C. Oral hairy leukoplakia in 71 HIV seropositive patients: clinical symptoms, relation to immunologic status and prognostic significance. J Am Acad Dermatol. 1996; 35: 928-34.
30. Triantos D, Porter SR, Scully C, Gee C. Oral hairy leukoplakia: clinicopathologic features, pathogenesis, diagnosis and clinical significance. Clin Infect Dis. 1997; 25: 1392-6.
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Cómo citar
Estrada Montoya, J. H., & Ramírez Rojas, D. A. (2015). Manifestaciones orales asociadas a la infección por el VIH/sida en la etapa de expansión de la terapéutica antirretroviral: una década en revisión (2000-2010) / Oral Manifestations Associated to HIV Infection under ART/HAART: Review of a Decade 2000-2010. Universitas Odontologica, 33(71), 175–189. https://doi.org/10.11144/Javeriana.uo33-71.moai
Sección
Salud Pública y Epidemiología Oral