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Abstract
RÉSUMÉ
Objectif. Évaluer l’impact de la co-infection tuberculeuse sur les lésions bucco-dentaires chez les sujets VIH+ en fonction de leur état immunitaire. Méthodes. L’étude était transversale, descriptive et analytique, de mars à juin 2020. Elle portait sur les patients mono-infectés par le VIH (groupe 1) et ceux co-infectés par la tuberculose (groupe 2) suivis à l’Hôpital Jamot de Yaoundé et disposant d’un dosage du taux de CD4 et de la charge virale de moins 3 mois. Les données diagnostiques et thérapeutiques d’intérêt en rapport avec le VIH et/ou la tuberculose et les données de l’examen bucco-dentaire ont été analysées à l’aide du logiciel SPSS 24.0 avec les statistiques descriptives usuelles. Le test de Chi-2 a été utilisé pour comparer les proportions entre deux groupes, l’odds ratio avec son intervalle de confiance à 95% évaluant le degré d’association entre les variables. Le seuil de significativité était p ≤ 0,05. Résultats. Quarante-huit patients ont été recrutés dans chaque groupe dans lequel le sex ratio était de 1 et la classe d’âge modale de 40-50 ans. Le taux de CD4+ moyen était plus faible et la charge virale moyenne plus élevée dans le groupe 2 (140±84 cellules/mm3 vs 312±62 cellules/mm3, p<0,001 et 8431 ± 3217,4 copies/ml vs 79269 ± 17766,2 copies/ml ; p<0,001 respectivement) si bien que les lésions buccodentaires y étaient 2 fois plus prévalentes (81,3% vs 73% ; OR= 2,12 ; IC à 95% : 1.37-10,6 ; p=0,036). Pour des CD4 < 200 cellules/mm3, la prévalence des lésions bucco-dentaires devenait similaire dans les 2 groupes (100% vs 90,2%, OR= 1,05 ; IC à 95% : 0.78-2,01 ; p=0,052). Conclusion. La co-infection tuberculeuse doublerait la probabilité de développer des lésions bucco-dentaires chez les sujets VIH+, ce, lorsque le taux de CD4+ > 200 cellules/mm3.
ABSTRACT
Objective. To assess the impact of tuberculosis co-infection on oral lesions in HIV + subjects according to their immune status. Methods. The study was cross-sectional, descriptive and analytical, from March to June 2020. It focused on patient’s mono-infected with HIV (group 1) and those co-infected with tuberculosis (group 2) followed at the Jamot hospital in Yaoundé and with a CD4 count and viral load assay of less than 3 months. The diagnostic and therapeutic data of interest in relation to HIV and / or tuberculosis and the data from the oral examination were analyzed using the SPSS 24.0 software with the usual descriptive statistics. The Chi-square test was used to compare the proportions between two groups, the odds ratio with its 95% confidence interval assessing the degree of association between the variables. The significance level was p ≤ 0.05. Results. Forty-eight patients were recruited from each group in which the sex ratio was 1 and the modal age group was 40-50 years. The mean CD4 + count was lower and the mean viral load higher in group 2 (140 ± 84 cells / mm3 vs 312 ± 62 cells / mm3, p <0.001 and 8431 ± 3217.4 copies / ml vs 79269 ± 17766, 2 copies / ml; p <0.001 respectively) so that oral lesions were twice as prevalent (81.3% vs 73%; OR = 2.12 95% CI: 1.37-10.6; p = 0.036). For CD4 < 200 cells / mm3, the prevalence of oral lesions was similar in the 2 groups (100% vs 90.2%, OR = 1.05 95% CI: 0.78-2.01; p = 0.052). Conclusion. Tuberculous co-infection would double the probability of developing oral lesions in HIV + subjects, when the CD count > 200 cells / mm3.
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References
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- - Tappuni AR, Fleming GJ. The effect of antiretroviral therapy on the prevalence of oral manifestations in HIV-infected patients: a UK study. Oral Surgery, Oral Medicine, Oral Patholology, Oral Radiology and Endodontics 2001;92:623-8.
- - Mindja Eko D, Ngaba Mambo ON, Meva’a Biouele RC, Badamo Gnomo S, Ngo Nyéki AR, Mossus Y, Atanga LC, Dangmo Layang, Kamgno J. Profil Épidémiologique et Clinique des Affections Stomatologiques chez les Patients Infectés par le VIH à l’Hôpital Régional de Maroua. Health Sci. Dis 2021 ; 22 (5) : 80-84
- - Margiotta V, Campisi G, Mancuso S, Accurso V, Abbadessa V. HIV infection: oral lesions, CD4+ cell count and viral load in an Italian study population. Journal of Oral Pathology and Medicine 1999;28:173-7.
- - Coogan M,Greenspan J, Challacombe SJ. Oral lesions in infection with human immunodeficiency virus. Bulletin of the World Health Organization 2005; 83 (9): 700-6
- - Glick M, Muzyka BC, Lurie D, Salkin LM. Oral manifestations associated with HIV-related disease as markers for immune suppression and AIDS. Oral Surgery, Oral Medicine and Oral Pathology 1994;77:344-9.
- - Coulter ID, Heslin KC, Marcus M, Hays RD, Freed J, Der-Martirosia C, et al. Associations of self-reported oral health with physical and mental health in a nationally representative sample of HIV persons receiving medical care. Quality of Life Research 2002;11:57-60.
- - Hodgson TA, Naidoo S, Chidzonga M, Ramos Gomez F, Shiboski C. Identification of oral health care needs in children and adults, management of oral diseases. Advances in Dental Research 2006; 19:106-117.
References
- Palmer GD, Robinson PG, Challacombe SJ, Birnbaum W, Croser D, Erridge PL et al. Aetiological factors for oral manifestations of HIV infection. Oral Diseases 1996;2:193-7.
- Greenspan JS, Greenspan D. The epidemiology of the oral lesions of HIV infection in the developed world. Oral Diseases 2002;8 Suppl 2:34-9.
- Badri M, Ehrlich R, Wood R. Association between tuberculosis and HIV disease progression in a high tuberculosis prevalence area. Int J Tuberc Lung Dis 2001;5:225-32
- Toossi Z. Virological and immunological impact of tuberculosis on human immudeficiency virus type 1 disease. J Infect Dis 2003;188:1146-55
- Patton LL, McKaig R, Strauss R, Rogers D, Eron JJJ. Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral Surgery, Oral Medicine, Oral Patholology, Oral Radiology and Endodontics 2000;89:299-304.
- Schmidt-Westhausen AM, Priepke F, Bergmann FJ, Reichart PA. Decline in the rate of oral opportunistic infections following introduction of highly active antiretroviral therapy. Journal of Oral Pathology and Medicine 2000;29:336-41.
- Tappuni AR, Fleming GJ. The effect of antiretroviral therapy on the prevalence of oral manifestations in HIV-infected patients: a UK study. Oral Surgery, Oral Medicine, Oral Patholology, Oral Radiology and Endodontics 2001;92:623-8.
- Mindja Eko D, Ngaba Mambo ON, Meva’a Biouele RC, Badamo Gnomo S, Ngo Nyéki AR, Mossus Y, Atanga LC, Dangmo Layang, Kamgno J. Profil Épidémiologique et Clinique des Affections Stomatologiques chez les Patients Infectés par le VIH à l’Hôpital Régional de Maroua. Health Sci. Dis 2021 ; 22 (5) : 80-84
- Margiotta V, Campisi G, Mancuso S, Accurso V, Abbadessa V. HIV infection: oral lesions, CD4+ cell count and viral load in an Italian study population. Journal of Oral Pathology and Medicine 1999;28:173-7.
- Coogan M,Greenspan J, Challacombe SJ. Oral lesions in infection with human immunodeficiency virus. Bulletin of the World Health Organization 2005; 83 (9): 700-6
- Glick M, Muzyka BC, Lurie D, Salkin LM. Oral manifestations associated with HIV-related disease as markers for immune suppression and AIDS. Oral Surgery, Oral Medicine and Oral Pathology 1994;77:344-9.
- Coulter ID, Heslin KC, Marcus M, Hays RD, Freed J, Der-Martirosia C, et al. Associations of self-reported oral health with physical and mental health in a nationally representative sample of HIV persons receiving medical care. Quality of Life Research 2002;11:57-60.
- Hodgson TA, Naidoo S, Chidzonga M, Ramos Gomez F, Shiboski C. Identification of oral health care needs in children and adults, management of oral diseases. Advances in Dental Research 2006; 19:106-117.