EPIDEMIOLOGY OF ORAL MANIFESTATIONS OF HIV DISEASE

HIV 疾病口腔表现的流行病学

• 批准号: 6104722
• 负责人: JOAN F HILTON
• 金额: $ 27.9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-05-01 至 2000-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6104722
• 关键词: AIDS; Herpesviridae disease; Kaposi's sarcoma; antiAIDS agent; aphthous stomatitis; candidiasis; clinical research; communicable disease diagnosis; disease /disorder classification; disease /disorder proneness /risk; drug resistance; epidemiology; human morbidity; human subject; opportunistic infections; oral health; oral leukoplakia; oral pharyngeal disorder; oral pharyngeal disorder diagnosis; prognosis; racial /ethnic difference; sex behavior; thrombocytopenic purpura; warts; zidovudine

We propose three sets of studies of the expression of oral lesions by HIV-infected people, varing from molecular epidemiology to traditional epidemiology. These analyses will be based on six cohort studies and one clinic population; three cohorts follow subjects from seroconversion (Tricontinental Seroconverter Study, HIVNET, and a subset of the S.F. Men's Health Study). The study populations include adolescents, women and men, who were infected with HIV through sex or injection drug use. Currently, both HIV viral load and oral lesions are being used as outcome measures in clinical trials of antiretroviral treatments, however, the relationship between these outcomes has not been characterized. Under Aim 1 we will study this relationship in three cohorts whose viral load is being measured serially. If we demonstrate a strong association, then the usefulness of oral lesions as markers of disease progression is enhanced, in part because periodic clinical examinations are far less expensive than viral load assays. The prognostic value of oral lesions for progression of HIV disease has led to their use in defining the CDC classification of HIV disease and prophylaxes for PCP. Much of this research has been based on cohorts of homosexual/bisexual men, some of which has not distinguished between types of oral lesions. We have observed striking differences in prevalence of lesion types by risk group, which may have implications for their role in clinical trails and as bases for therapeutic management of HIV disease. Under Aim 2 we continue our studies of the incidence, prognostic value, and risk factors of oral lesions by risk group. Clinicians increasingly are reporting cases of azole resistance among HIV-infected subjects with very low CD4 counts. Resistance arising through replacement of a susceptible isolate with a resistant isolate from a different species raises the question of the role of person-to-person transmission and the potential for prevention of primary infection. Under Aim 3 we propose to conduct a case-control of azole-resistant candidiasis with DNA fingerprinting of isolates using the Ca2 probe.

我们提出了三套研究的表达口头 艾滋病毒感染者的病变，从分子 流行病学与传统流行病学的区别 这些分析将 基于六项队列研究和一个临床人群;三个 队列跟踪血清转换（三大陆性）的受试者 血清转化者研究、HIVNET和S.F. Men的一个子集 健康研究）。 研究人群包括青少年、女性 通过性行为或注射毒品感染艾滋病毒的男性 使用. 目前，艾滋病毒载量和口腔病变都在使用 作为抗逆转录病毒临床试验的结果指标 然而，这些结果之间的关系 没有被定性。 在目标1下，我们将研究这一点 正在测量病毒载量的三个队列中的关系 连续地。 如果我们证明了一个强关联，那么 口腔病变作为疾病进展标志物的有用性 加强，部分原因是定期临床检查， 比病毒载量检测更便宜。 口腔病变对HIV进展的预后价值 疾病导致他们在定义CDC分类中使用 艾滋病和肺炎的症状。 这项研究的大部分 基于同性恋/双性恋男性群体， 它没有区分口腔病变的类型。 我们 已经观察到病变类型的患病率存在显著差异， 这可能会影响到他们在以下方面的作用： 作为艾滋病毒治疗管理的基础 疾病 在目标2下，我们继续研究发病率， 预后价值和风险因素的口腔病变的风险组。 临床医生越来越多地报告唑类耐药病例 在CD 4计数非常低的HIV感染者中。 通过替换敏感分离株产生的耐药性 与来自不同物种的耐药菌株进行杂交， 人与人之间传播的作用问题以及 预防原发性感染的潜力。 根据目标3， 建议进行耐唑念珠菌病的病例对照 用Ca 2探针对分离株进行DNA指纹分析。