ORAL CANDIDIASIS IN HIGH-RISK PATIENTS AS THE INITIAL MANIFESTATION OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME
ORAL CANDIDIASIS IN HIGH-RISK PATIENTS AS THE INITIAL MANIFESTATION OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME
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DOI：
10.1056/nejm198408093110602
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
FRIEDLAND, GH
中科院分区：
文献类型：
--
作者：
KLEIN, RS;HARRIS, CA;FRIEDLAND, GH
对不明原因的口腔念珠菌感染导致高危患者明确的获得性免疫缺陷综合征(AIDS)的频率进行了研究。22名先前患有不明原因口腔念珠菌病的健康成年人，其中19人T4/T8比率倒置，20人患有全身淋巴结病，与20名T4/T8比率倒置和全身淋巴结病的相似患者进行比较，后者没有口腔念珠菌病。所有人都是静脉注射。吸毒者，同性恋者或双性恋者，或两者兼而有之。22例口腔念珠菌病患者中，13例(59%)在中位时间3个月内发生重大机会性感染或卡波西S肉瘤。(范围1-23)与20例全身淋巴结病和免疫缺陷但无念珠菌病的患者相比，这些患者平均随访12个月。(5-21)(P<；0.001)。15例念珠菌病患者中有12例发展为艾滋病，其T4/T8比值为1。0.51，而比率为.gtoreq的4个国家中没有一个。0.60(P<；0.01)。在艾滋病高危患者中，原因不明的口腔念珠菌病的存在预示着50%的时间会发生严重的机会性感染。其余的人是否会感染艾滋病尚不清楚。
The frequency with which unexplained oral candidiasis led to unequivocal acquired immunodeficiency syndrome (AIDS) in patients at risk was studied. Twenty-two previously healthy adults with unexplained oral candidiasis, of whom the 19 tested had a reversed T4/T8 ratio and 20 had generalized lymphadenopathy, were compared with 20 similar patients with a reversed T4/T8 ratio and generalized lymphadenopathy who did not have oral candidiasis. All were i.v. drug abusers, homosexual or bisexual men, or both. Thirteen of the 22 patients with oral candidiasis (59%) acquired a major opportunistic infection or Kaposi''s sarcoma at a median of 3 mo. (range, 1-23) as compared with none of 20 patients with generalized lymphadenopathy and immunodeficiency but without candidiasis who were followed for a mean of 12 mo. (range, 5-21) (P < 0.001). AIDS developed in 12 of 15 patients with candidiasis and T4/T8 ratios .ltoreq. 0.51, as compared with none of 4 with ratios .gtoreq. 0.60 (P < 0.01). In patients at high risk for AIDS, the presence of unexplained oral candidiasis predicts the development of serious opportunistic infections > 50% of the time. Whether the remainder will have AIDS is not yet known.