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ID 113552
Title Alternative
Clinico-statistical study of HIV patients in clinical dental departments at Tokushima University Hospital
Author
Yamanoi, Tomoko Tokushima University
Keywords
HIV感染者
合併症
口腔管理
日和見感染症
HIV patients
complications
oral management
opportunistic infection
Content Type
Journal Article
Description
HIV 感染症診療は,免疫不全の原因治療と免疫不全に伴う日和見感染症の管理が2 本柱とされる.日和見感染症の管理という観点から,口腔衛生管理は重要で歯科医師の果たす役割は大きい.われわれは,徳島大学病院歯科診療科を受診した31 例のHIV 感染者の臨床統計的検討を行い,今後増加すると予想されるHIV感染者に対する歯科医療の留意点について考察した.症例は男性29 例,女性2 例で,平均年齢は31.7 ± 12.4歳であった.感染経路は血液製剤による感染が8 例,性感染による感染が23 例であった.31 例中3 例で抗HIV 療法が導入されていなかった.HIV 感染者の合併症の保有率は高く,血友病群ではHCV 感染症(75.0%),C 型肝硬変(37.5%)が多く,性感染症群では梅毒(30.4%),HBV 感染症(21.7%)が多かった.歯科診断では歯周病,う蝕が多かったが,31 例中7 例に口腔粘膜疾患を認めた.歯科治療内容は抜歯処置15 例,歯周治療12 例,修復治療5 例の順に多かった.血友病群の抜歯の際は血液凝固製剤を術前・術後に補充して抜歯を行った.
HIV 感染者の歯科医療は,医科と連携し患者個々のHIV 感染症の病態や合併症を把握し,日和見疾患のリスク因子である口腔感染症を治療し,予防する必要がある.そして,患者にHIV 感染症と口腔症状の関連性と定期的な歯科治療の必要性を説明し,患者にあわせた無理のない口腔衛生指導を行いながら,長期的なメインテナンスが必要であると考えられた.
Description Alternative
To prevent opportunistic infectious disease in HIV patients with immunodeficiency, oral management is important. In order to identify focal points in dental treatment, we studied the 31 HIV patients( 29 males and 2 females, mean age 31.7±12.4 years) who visited the clinical dental departments of Tokushima University Hospital from 1981 to 2016. Among the 31 cases, 3 cases did not start antiretroviral therapy (ART). The HIV patients were classified by infection route, producing a hemophilia group (8 cases) and sexually transmitted disease group( 23 cases). Clinical complications were different in these two groups: complications in the hemophilia group included hepatitis C virus (HCV) infection (75.0%) and hepatitis C-related cirrhosis (37.5%), whereas in the sexually transmitted disease group complications included syphilis (30.4%) and hepatitis B virus (HBV) infection (21.7%). There were many dental caries and periodontal diseases found in the patients. On the other hand, oral mucosal diseases were observed in seven of 31 cases. Dental treatment consisted of tooth extraction in 15 cases, periodontal treatment in 12 cases, and caries treatment in 5 cases. Blood coagulation formulation was supplied during tooth extraction in the hemophilia group.
Careful attention must be given according to the condition of each HIV patient during dental treatment, and the risk of opportunistic infection caused by oral infection must be treated and prevented.
Journal Title
Journal of Japanese Society of Dentistry for Medically Compromised Patient
ISSN
09188150
NCID
AN10401297
Publisher
日本有病者歯科医療学会
Volume
26
Issue
6
Published Date
2017-12
EDB ID
FullText File
language
jpn
TextVersion
Author
departments
University Hospital
Oral Sciences