kurskvestЧеловек и его здоровьеHumans and their health1998-57461998-5754Kursk State Medical University10.21626/vestnik/2023-4/05QSFBTJkurskvest-1235Research ArticleПРОФИЛАКТИЧЕСКАЯ МЕДИЦИНАPREVENTATIVE MEDICINEПроявления ВИЧ-инфекции в полости рта у пациентов в зависимости от содержания CD4+ Т-лимфоцитов в кровиOral manifestations of HIV-infection in patients based on CD4+ T-lymphocyte countshttps://orcid.org/0000-0002-9159-2165ЛегкихАлександр ВладимировичLyogkihAlexander V.

канд. мед. наук, доцент кафедры терапевтической стоматологии и пропедевтики стоматологических заболеваний, УГМУ, г. Екатеринбург

Cand Sci. (Med.), Associate Professor at the Department of Therapeutic Dentistry and Propaedeutics of Dental Diseases, USMU, Yekaterinburg, Russian Federation

lyogkih@ya.ruhttps://orcid.org/0000-0003-1223-5790ГайсинаЕлена ФахаргалеевнаGaisinaElena F.

канд. мед. наук, доцент кафедры фармакологии и клинической фармакологии, УГМУ, г. Екатеринбург

Cand Sci. (Med.), Associate Professor at the Department of Pharmacology and Clinical Pharmacology, USMU, Yekaterinburg, Russian Federation

egaisina68@mail.ruhttps://orcid.org/0000-0001-9208-9417ДобринскаяМария НиколаевнаDobrinskayaMaria N.

канд. мед. наук, доцент кафедры фармакологии и клинической фармакологии, УГМУ, г. Екатеринбург

Cand Sci. (Med.), Associate Professor at the Department of Pharmacology and Clinical Pharmacology, USMU, Yekaterinburg, Russian Federation

maria-nd@mail.ruhttps://orcid.org/0009-0005-0214-5881ОмельковаЕкатерина АндреевнаOmelkovaEkaterina A.

студент, УГМУ, г. Екатеринбург

student, USMU, Yekaterinburg, Russian Federation

eomelkova02@mail.ruhttps://orcid.org/0009-0006-1852-0380АстрюхинаПолина ИгоревнаAstryukhinaPolina I.

студент, УГМУ, г. Екатеринбург

student, USMU, Yekaterinburg, Russian Federation

astryukhina_polina@mail.ruУральский государственный медицинский университет (УГМУ)РоссияUral State Medical University (USMU)Russian Federation2023291220232645464Copyright © Легких А.В., Гайсина Е.Ф., Добринская М.Н., Омелькова Е.А., Астрюхина П.И., 20242024Легких А.В., Гайсина Е.Ф., Добринская М.Н., Омелькова Е.А., Астрюхина П.И.Lyogkih A.V., Gaisina E.F., Dobrinskaya M.N., Omelkova E.A., Astryukhina P.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.kursk-vestnik.ru/jour/article/view/1235

Цель исследования - анализ и обобщение имеющихся данных о проявлениях вируса иммунодефицита человека в полости рта в зависимости от количества CD4+ Т-лимфоцитов в крови. Материалы и методы. Поиск клинических исследований, систематических обзоров и сетевых мета-анализов был проведен в период с 2004-2023 годы в базах данных PubMed, Elsiever, Scopus, Cochrane и Elibrary, в которых были описаны проявления ВИЧ-инфекции в полости рта в зависимости от количества CD4+ Т-лимфоцитов. Результаты. Псевдомембранозный кандидоз, «волосатая» лейкоплакия, саркома Капоши, неходжкинская лимфома развиваются на фоне тяжелого иммунодефицита при количестве CD4+ Т-лимфоцитов <200 клеток/мкл крови. Саркома Капоши также развивается у людей с высоким количеством CD8+Т-лимфоцитов (>1000 клеток/мкл крови) или с низким соотношением CD4+ к CD8+ (CD4+:CD8+ ≤0,5). Неходжкинская лимфома развивается не только при CD4+T-клетках <200/мкл, но и при высоком количестве CD8+Т-клеток (≥2000 клеток/мкл крови). Специфические заболевания пародонта развиваются при умеренном и выраженном иммунодефиците (CD4+ Т-клеток 200-500 клеток/мкл крови). Язвенно-некротический гингивит чаще наблюдается при тяжелом иммунодефиците (CD4+ Т-лимфоцитов <200 клеток/мкл). Заключение. Развитие псевдомембранозного кандидоза (p<0,05), «волосатой» лейкоплакии (p<0,01), саркомы Капоши (p<0,0001) статистически значимо коррелирует с количеством CD4+ T-лимфоцитов <200 клеток/мкл крови. Кроме того, на развитие саркомы Капоши помимо низкого количества CD4+ T-клеток влияет высокое число СD8+ цитотоксических лимфоцитов >1000 клеток/мкл (p=0,0003) и низкое соотношение CD4+:CD8+ ≤0,5 (p<0,0003), что является статистически значимым.

Objective - analysis and generalization of the available data on the manifestations of human immunodeficiency virus in the oral cavity depending on the number of CD4+ T-lymphocytes in the blood. Materials and methods. A search of clinical studies, systematic reviews, and online meta-analyses was conducted from 2004-2023 in the PubMed, Elsiever, Scopus, Cochrane, and Elibrary databases, which described oral manifestations of HIV infection as a function of CD4+ T-lymphocyte count. Results. Pseudomembranous candidiasis, hairy leukoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma develop against a background of severe immunodeficiency when the CD4+ T-lymphocyte count is <200 cells/μL blood. Kaposi's sarcoma also develops in people with a high CD8+ T-lymphocyte count (>1000 cells/μL of blood) or with a low CD4+ to CD8+ ratio (CD4+:CD8+ ≤0.5). Non-Hodgkin's lymphoma develops not only with CD4+ T-cells <200/μL, but also with a high number of CD8+ T-cells (≥2000 cells/μL of blood). Specific periodontal disease develops with moderate to severe immunodeficiency (CD4+ T-cells 200-500 cells/μL of blood). Necrotic ulcerative gingivitis is more often seen in severe immunodeficiency (CD4+ T-lymphocytes <200 cells/μL). Conclusion. The development of pseudomembranous candidiasis (p<0,05), "hairy" leukoplakia (p<0,01), Kaposi sarcoma (p<0,0001) statistically significantly correlates with CD4+ T-lymphocyte count <200 cells/μl blood. In addition, the development of Kaposi's sarcoma, in addition to the low number of CD4+ T-cells, is affected by a high number of CD8+ cytotoxic lymphocytes >1000 cells/μL (p=0.0003) and a low CD4+:CD8+ ratio ≤0.5 (p<0.0003), which is statistically significant.

кандидозсаркома Капоши«волосатая» лейкоплакиянеходжкинская лимфомалинейная эритема десенязвенно-некротический пародонтитязвенно-некротический гингивитcandidiasisKaposi sarcoma"hairy" leukoplakianon-Hodgkin lymphomalinear gum erythemaulcerative and necrotizing periodontitisulcerative and necrotizing gingivitisReferencesНациональная ассоциация специалистов Министерства здравоохранения Российской Федерации по профилактике, диагностике и лечению ВИЧ-инфекции. Клинические рекомендации: ВИЧ-инфекция у взрослых. 2020. 10 с. URL: https://cr.minzdrav.gov.ru/recomend/79_1The National Association of Specialists of the Ministry of Health of the Russian Federation for the prevention, diagnosis and Treatment of HIV infection. Clinical recommendations: HIV infection in adults. 2020. 10 p.. URL: https://cr.minzdrav.gov.ru/recomend/79_1Радзиховская М.В., Москвичева М.Г., Кафеева Э.И. Нормативно-правовое обеспечение организации медицинской помощи пациентам с ВИЧ-инфекцией на федеральном и региональном уровнях (историческая справка). Уральский медицинский журнал. 2018;(4):119-125. DOI: 10.25694/URMJ.2018.04.052. EDN: UTKFES.Radzikhovskaya M.V., Moskvicheva M.G., Kafeeva E.I. Regulatory support for the organization of medical care for patients with HIV infection at the federal and regional levels (historical overview). Ural Medical Journal. 2018;(4):119-125 (in Russ.). DOI: 10.25694/URMJ.2018.04.052. EDN: UTKFES.Zhu L. 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. Oral Pathol Med. 2013;22(7):289-291.Zhu L. 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. Oral Pathol Med. 2013;22(7):289-291.Berberi A., Noujeim Z. Epidemiology and relationships between CD4+ counts and oral lesions among 50 patients infected with human immunodeficiency virus. J Int Oral Health. 2015;7(1):18-21.Berberi A., Noujeim Z. Epidemiology and relationships between CD4+ counts and oral lesions among 50 patients infected with human immunodeficiency virus. J Int Oral Health. 2015;7(1):18-21.Ruterbusch M., Pruner K.B., Shehata L., Pepper M. In vivo CD4(+) T-cell differentiation and function: revisiting the Th1/Th2 paradigm. Annu Rev Immunol. 2020;38:705-725. DOI: 10.1146/annurev-immunol-103019-085803.Ruterbusch M., Pruner K.B., Shehata L., Pepper M. In vivo CD4(+) T-cell differentiation and function: revisiting the Th1/Th2 paradigm. Annu Rev Immunol. 2020;38:705-725. DOI: 10.1146/annurev-immunol-103019-085803.Dang A.T., Cotton S., Sankaran-Walters S., Li C.S., Lee C.Y., Dandekar S., Paster B.J., George M.D. Evidence of an increased pathogenic footprint in the lingual microbiome of untreated HIV infected patients. BMC Microbiol. 2012;12:153-155. DOI: 10.1186/1471-2180-12-153.Dang A.T., Cotton S., Sankaran-Walters S., Li C.S., Lee C.Y., Dandekar S., Paster B.J., George M.D. Evidence of an increased pathogenic footprint in the lingual microbiome of untreated HIV infected patients. BMC Microbiol. 2012;12:153-155. DOI: 10.1186/1471-2180-12-153.Gannepalli A., Krishna A.B., Baghirath P.V., Vinay B.H., Khaled S., Anjum B. Oral manifestations in HIV-TB сo-infected patients and their correlation with CD4 count in Telangana state, India. J Int Soc Prev Community Dent. 2020;10(1):21-35. DOI: 10.4103/jispcd.JISPCD_448_18.Gannepalli A., Krishna A.B., Baghirath P.V., Vinay B.H., Khaled S., Anjum B. Oral manifestations in HIV-TB сo-infected patients and their correlation with CD4 count in Telangana state, India. J Int Soc Prev Community Dent. 2020;10(1):21-35. DOI: 10.4103/jispcd.JISPCD_448_18.Balaji T.M., Varadarajan S., Sujatha G., Muruganandhan J., Shanmugapriya R., Raj A.T., Patil S., Fageeh H.I., Fageeh H.N., Malik N.H., Awan K.H. Necrotizing periodontal diseases in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy: a review. Dis Mon. 2021;67(9):101168. DOI: 10.1016/j.disamonth.2021.101168.Balaji T.M., Varadarajan S., Sujatha G., Muruganandhan J., Shanmugapriya R., Raj A.T., Patil S., Fageeh H.I., Fageeh H.N., Malik N.H., Awan K.H. Necrotizing periodontal diseases in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy: a review. Dis Mon. 2021;67(9):101168. DOI: 10.1016/j.disamonth.2021.101168.Li S., Su B., He Q.S., Wu H., Zhang T. Alterations in the oral microbiome in HIV infection: causes, effects and potential interventions. Chin Med J. 2021;134:2788-2798. DOI: 10.1097/CM9.0000000000001825.Li S., Su B., He Q.S., Wu H., Zhang T. Alterations in the oral microbiome in HIV infection: causes, effects and potential interventions. Chin Med J. 2021;134:2788-2798. DOI: 10.1097/CM9.0000000000001825.Еловикова Т.М., Гайсина Е.Ф., Приходкин А.С. Применение антибактериальных препаратов при агрессивных формах пародонтита. Обзор литературы. Проблемы стоматологии. 2019;415(1):10-15. DOI: 10.18481/2077-7566-2018-15-1-10-15. EDN: EQEZHC.Elovikova T.M., Gajsina E.F., Prihodkin A.S. Use of antibacterial drugs for the treatment of aggressive periodontitis. Literature review. Problemy stomatologii. 2019;415(1):10-15 (in Russ.). DOI: 10.18481/2077-7566-2018-15-1-10-15. EDN: EQEZHC.Хаирова Я.Р., Скороделова М.И., Никольская М.В. Оппортунистические инфекции при ВИЧ-инфекции. Медицина и здравоохранение. 2021;(2):69-72KHairova YA.R., Skorodelova M.I., Nikol'skaya M.V. Opportunistic infections in HIV infection. Medicina i zdravoohranenie. 2021;(2):69-72 (in Russ.)Давлеева Б.А. Современные аспекты патогенеза и лечения кандидоза полости рта. Вестник КазНМУ. 2014;(1):32-36.EDN: DLPQVE.Davleeva B.A. Modern aspects of the pathogenesis and treatment of oral candidiasis. Vestnik KazNMU. 2014;(1):32-36 (in Russ.). EDN: DLPQVE.Афтаева Л.Н., Мельников В.Л., Вотолкина С.В., Судапина А.Р., Никольская М.В. Особенности ВИЧ-инфекции у взрослых. Сибирский научный медицинский журнал. 2020;(4):86-90. DOI: 10.15372/SSMJ20200412. EDN: CBYVAE.Aftaeva L.N., Mel'nikov V.L., Votolkina S.V., Sudapina A.R., Nikol'skaya M.V. Features of HIV infection in adults. Siberian scientific medical journal. 2020;(4):86-90 (in Russ.). DOI: 10.15372/SSMJ20200412. EDN: CBYVAE.Прожерин С.В., Подымова А.С., Рямова Е.П. Клинические маркеры выраженной иммуносупрессии у больных ВИЧ-инфекцией в Cвердловской области на примере волосатой лейкоплакии. Клиническая дерматология и венерология. 2017;16(6):54-61. DOI: 10.17116/klinderma201716654-6.Prozherin S.V., Podymova A.S., Ryamova E.P. Clinical markers of severe immunosuppression in patients with HIV infection in the Sverdlovsk region on the example of hairy leukoplakia. Klinicheskaya dermatologiya i venerologiya. 2017;16(6):54-61 (in Russ.). DOI: 10.17116/klinderma201716654-6.Гилева О.С., Садилова В.А. Заболевания пародонта у ВИЧ-инфицированных больных: распространенность и особенности клинических проявлений в зависимости от приверженности антиретровирусной терапии. Пермский медицинский журнал. 2013;30(2):34-42. EDN: QAQOKD.Gileva O.S, Sadilova V.A. Periodontal disease in HIV-infected patients: prevalence and features of clinical manifestations depending on adherence to antiretroviral therapy. Permskij medicinskij zhurnal. 2013;30(2):34-42 (in Russ.). EDN: QAQOKD.Атанова И.А. ВИЧ-ассоциированные неходжкинские лимфомы. Вестник совета молодых учёных и специалистов Челябинской области. 2019;4(27):3-8. EDN: JXBSDE.Atanova I.A. HIV-associated non-Hodgkin's lymphomas. Vestnik soveta molodyh uchyonyh i specialistov Chelyabinskoj oblasti. 2019;4(27):3-8 (In Russ.). EDN: JXBSDE.Phiri R., Feller L., Blignaut E. The severity, extent and recurrence of necrotizing periodontal disease in relation to HIV status and CD4+ T-cell count. J Int Acad Periodontol. 2010;12(4):98-103.Phiri R., Feller L., Blignaut E. The severity, extent and recurrence of necrotizing periodontal disease in relation to HIV status and CD4+ T-cell count. J Int Acad Periodontol. 2010;12(4):98-103.Zhu J. T-helper cell differentiation, heterogeneity and plasticity. Cold Spring Harb Perspect Biol. 2018;10(10):a030338. DOI: 10.1101/cshperspect.a030338.Zhu J. T-helper cell differentiation, heterogeneity and plasticity. Cold Spring Harb Perspect Biol. 2018;10(10):a030338. DOI: 10.1101/cshperspect.a030338.Zhu X., Zhu J. CD4 T helper cell subsets and related human immunological disorders.Int J Mol Sci. 2020;21(21):8011. DOI: 10.3390/ijms21218011.Zhu X., Zhu J. CD4 T helper cell subsets and related human immunological disorders.Int J Mol Sci. 2020;21(21):8011. DOI: 10.3390/ijms21218011.Kunkl M., Frascolla S., Amormino C., Volpe E., Tuosto L. T helper cells: the modulators of inflammation in multiple sclerosis. Cells. 2020;9(2):482. DOI: 10.3390/cells9020482.Kunkl M., Frascolla S., Amormino C., Volpe E., Tuosto L. T helper cells: the modulators of inflammation in multiple sclerosis. Cells. 2020;9(2):482. DOI: 10.3390/cells9020482.Stockinger B., Veldhoen M. Differentiation and function of Th17 T cells. Curr Opin Immunol. 2007;19:281-286. DOI: 10.1016/j.coi.2007.04.005.Stockinger B., Veldhoen M. Differentiation and function of Th17 T cells. Curr Opin Immunol. 2007;19:281-286. DOI: 10.1016/j.coi.2007.04.005.Heron S.E., Elahi S. HIV infection and compromised mucosal immunity: oral manifestations and systemic inflammation. Front Immunol. 2017;8:241-245. DOI: 10.3389/fimmu.2017.00241.Heron S.E., Elahi S. HIV infection and compromised mucosal immunity: oral manifestations and systemic inflammation. Front Immunol. 2017;8:241-245. DOI: 10.3389/fimmu.2017.00241.Schreiber F., Arasteh J.M., Lawley T.D. Pathogen resistance mediated by IL-22 signaling at the epithelial-microbiota interface. J Mol Biol. 2015;427:3676-3682. DOI: 10.1016/j.jmb.2015.10.013.Schreiber F., Arasteh J.M., Lawley T.D. Pathogen resistance mediated by IL-22 signaling at the epithelial-microbiota interface. J Mol Biol. 2015;427:3676-3682. DOI: 10.1016/j.jmb.2015.10.013.Song W., Craft J. T follicular helper cell heterogeneity: time, space and function. Immunol Rev. 2019;288(1):85-96. DOI: 10.1111/imr.12740.Song W., Craft J. T follicular helper cell heterogeneity: time, space and function. Immunol Rev. 2019;288(1):85-96. DOI: 10.1111/imr.12740.Mason M.R., Chambers S., Dabdoub S.M., Thikkurissy S., Kumar P.S. Characterizing oral microbial communities across dentition states and colonization niches. Microbiome. 2018;6(1):67. DOI: 10.1186/s40168-018-0443-2.Mason M.R., Chambers S., Dabdoub S.M., Thikkurissy S., Kumar P.S. Characterizing oral microbial communities across dentition states and colonization niches. Microbiome. 2018;6(1):67. DOI: 10.1186/s40168-018-0443-2.Gruffaz M., Zhang T., Marshall V., Gonçalves P., Ramaswami R., Labo N., Whitby D., Uldrick T.S., Yarchoan R., Huang Y., Gao S.J. Signatures of oral microbiome in HIV-infected individuals with oral Kaposi's sarcoma and cell-associated KSHV DNA. PLoS Pathog. 2020;16(1):e1008114. DOI: 10.1371/journal.ppat.1008114.Gruffaz M., Zhang T., Marshall V., Gonçalves P., Ramaswami R., Labo N., Whitby D., Uldrick T.S., Yarchoan R., Huang Y., Gao S.J. Signatures of oral microbiome in HIV-infected individuals with oral Kaposi's sarcoma and cell-associated KSHV DNA. PLoS Pathog. 2020;16(1):e1008114. DOI: 10.1371/journal.ppat.1008114.Li J., Chang S., Guo H., Ji Y., Jiang H., Ruan L., Du M. Altered salivary microbiome in the early stage of HIV infections among young chinese men who have sex with men (MSM). Pathogens. 2020;9(11):960. DOI: 10.3390/pathogens9110960.Li J., Chang S., Guo H., Ji Y., Jiang H., Ruan L., Du M. Altered salivary microbiome in the early stage of HIV infections among young chinese men who have sex with men (MSM). Pathogens. 2020;9(11):960. DOI: 10.3390/pathogens9110960.Yang L., Dunlap D.G., Qin S., Fitch A., Li K., Koch C.D., Nouraie M., DeSensi R., Ho K.S., Martinson J.J., Methé B., Morris A. Alterations in oral microbiota in HIV. Am J Respir Crit Care Med. 2020;201(4):445-457. DOI: 10.1164/rccm.201905-1016OC.Yang L., Dunlap D.G., Qin S., Fitch A., Li K., Koch C.D., Nouraie M., DeSensi R., Ho K.S., Martinson J.J., Methé B., Morris A. Alterations in oral microbiota in HIV. Am J Respir Crit Care Med. 2020;201(4):445-457. DOI: 10.1164/rccm.201905-1016OC.Баяхметова А.А., Екешева А.А. Исследование пародонтопатогенной микрофлоры пародонтальных карманов при пародонтите молекулярно-генетическим методом. Наука и мир. 2016;3(31):73-76. EDN: VPRNKD.Bayahmetova A.A., Ekesheva A.A. The study of periodontopathogenic microflora of periodontal pockets in periodontitis by molecular genetic method. Nauka i mir. 2016;3(31):73-76 (In Russ.). EDN: VPRNKD.Филина Ю.С., Шатохин А.И., Волчкова Е.В., Несвижский Ю.В., Пак С.Г. Влияние антимикотической терапии на видовой и штаммовый состав грибов рода Candida полости рта больных ВИЧ-инфекцией. Стоматология. 2018;97(6):28-33. DOI: 10.17116/stomat20189706128. EDN: YROPDN.FilinaYu.S., Shatokhin A.I., Volchkova E.V., NesvizhskiyYu.V., Pak S.G. Antimycotic therapy impacton oral mucosa Candida species composition in HIV-infected patients. Stomatologiya. 2018;97(6):28-33 (in Russ.). DOI: 10.17116/stomat20189706128. EDN: YROPDN.Захаров А.А., Ильина Н.А. Анализ микрофлоры ротовой полости обследованных людей с различными заболеваниями. Успехи современного естествознания. 2007;12(3):141-143.EDN: IJMAUF.Zaharov A.A., Il'ina N.A. Analysis of the microflora of the oral cavity of examined people with various diseases. Uspekhi sovremennogo estestvoznaniya. 2007;12(3):141-143 (in Russ.). EDN: IJMAUF.Сахарук Н.А. Микробная флора полости рта в норме и патологии. Морфология грибов рода Сandida. Вестник ВГМУ. 2008;7(2):2-11.Saharuk N.A. Microbial flora of the oral cavity in normal and pathological conditions. Morphology of fungi of the genus Candida. Vestnik VGMU. 2008;7(2):2-11 (in Russ.)Царев В.Н., Николаева Е.Н., Ягодина Е.В., Трефилова Ю.А., Ипполитов Е.В. Молекулярные методы диагностики гингивита и пародонтита у ВИЧ-инфицированных пациентов. Клиническая лабораторная диагностика. 2016;61(1):54-59. EDN: VOTJZV.Tsarev V.N., Nikolaeva E.N., YAgodina E.V., Trefilova YU.A., Ippolitov E.V. Molecular methods for diagnosing gingivitis and periodontitis in HIV-infected patients. Clinical laboratory diagnostics. 2016;61(1):54-59 (in Russ.). EDN: VOTJZV.Азатян В.Ю. Влияние высокоактивной антиретровирусной терапии на слизистую оболочку рта и пародонта при ВИЧ-инфекции. Вестник стоматологии и челюстно-лицевой хирургии. 2019;15(4):26-30.Azatyan V.Yu. Influence of highly active antiretroviral therapy on the mucosa of the mouth and periodont in HIV-infection. Vestnik stomatologii i chelyustno-licevojhirurgii. 2019;15(4):26-30 (in Russ.)Ермуханова Г.Т., Джандаулетова Н.Б., Каркимбаева Г.А., Ермуханова Н.Т. Клиническое течение проявлений ВИЧ-инфекции в полости рта у детей.Int Sci Pract Conf. 2017;5(18):35-41Ermuhanova G.T., Dzhandauletova N.B., Karkimbaeva G.A., Ermuhanova N.T. Clinical course of manifestations of HIV infection in the oral cavity in children.Int Sci Pract Conf. 2017;5(18):35-41 (in Russ.)Ottria L., Lauritano D., Oberti L., Candotto V., Cura F., Tagliabue A., Tettamanti L. Prevalence of HIV-related oral manifestations and their association with HAART and CD4+ T cell count: a review. J Biol Regul Homeost Agents. 2018;32(2.1):51-59.Ottria L., Lauritano D., Oberti L., Candotto V., Cura F., Tagliabue A., Tettamanti L. Prevalence of HIV-related oral manifestations and their association with HAART and CD4+ T cell count: a review. J Biol Regul Homeost Agents. 2018;32(2.1):51-59.Garcia S.A., Guzman N. Acquired immune deficiency syndrome CD4+. Count. Stat Pearls. 2022;1(1): 130-132.Garcia S.A., Guzman N. Acquired immune deficiency syndrome CD4+. Count. Stat Pearls. 2022;1(1): 130-132.Patil S., Majumdar B., Sarode S.C., Sarode G.S., Awan K.H. Oropharyngeal candidosis in HIV-infected patients-an update. Front Microbiol. 2018;9:980. DOI: 10.3389/fmicb.2018.00980.Patil S., Majumdar B., Sarode S.C., Sarode G.S., Awan K.H. Oropharyngeal candidosis in HIV-infected patients-an update. Front Microbiol. 2018;9:980. DOI: 10.3389/fmicb.2018.00980.Vazquez J.A. Therapeutic options for the management of oropharyngeal and esophageal candidiasis in HIV/AIDS patients. HIV Clin Trials. 2015;1(1):47-59. DOI: 10.1310/T7A7-1E63-2KA0-JKWD.Vazquez J.A. Therapeutic options for the management of oropharyngeal and esophageal candidiasis in HIV/AIDS patients. HIV Clin Trials. 2015;1(1):47-59. DOI: 10.1310/T7A7-1E63-2KA0-JKWD.Полянская Л.Н. Особенности проявлений ВИЧ-инфекции в полости рта. Современная стоматология. 2017;1(1):60-63. EDN: YGWQHJ.Polyanskaya L.N. Features of the manifestations of HIV infection in the oral cavity. Sovremennaya stomatologiya. 2017;1(1):60-63 (in Russ.). EDN: YGWQHJ.Михед Т.М., Красавцев Е.Л., Редько Д.Д. Кандидоз ротовой полости у ВИЧ-инфицированных. Проблемы здоровья и экологии. 2010;(1):43-47. DOI: 10.51523/2708-6011.2010-7-1-10.Mihed T.M., Krasavcev E.L., Red'ko D.D. Oral candidias is in HIV-infected patients. Problemy zdorov'ya i ekologii. 2010;(1):43-47 (In Russ.). DOI: 10.51523/2708-6011.2010-7-1-10.Repentigny L., Lewandowski D., Jolicoeur P. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev. 2004;17(4):729-759. DOI: 10.1128/CMR.17.4.729-759.2004.Repentigny L., Lewandowski D., Jolicoeur P. Immunopathogenesis of oropharyngeal candidiasis in human immunodeficiency virus infection. Clin Microbiol Rev. 2004;17(4):729-759. DOI: 10.1128/CMR.17.4.729-759.2004.Kerdpon D., Pongsiriwet S., Pangsomboon K., AIamaroon L., Kampoo K., Sretrirutchai S., Geater A., Robison V. Oral manifestations of HIV infection in relation to clinical and CD4 immunological status in northern and southern patients. Oral diseases. 2004;10(3):138-144. DOI: 10.1046/j.1601-0825.2003.00990.x.Kerdpon D., Pongsiriwet S., Pangsomboon K., AIamaroon L., Kampoo K., Sretrirutchai S., Geater A., Robison V. Oral manifestations of HIV infection in relation to clinical and CD4 immunological status in northern and southern patients. Oral diseases. 2004;10(3):138-144. DOI: 10.1046/j.1601-0825.2003.00990.x.De Almeida V.L., Lima I.F.P., Ziegelmann P.K., Paranhos L.R., De Matos F.R. Impact of highly active antiretroviral therapy on the prevalence of oral lesions in HIV-positive patients: a systematic review and meta-analysis.Int J Oral Maxillofac Surg. 2017;46(11):1497-1504. DOI: 10.1016/j.ijom.2017.06.008.De Almeida V.L., Lima I.F.P., Ziegelmann P.K., Paranhos L.R., De Matos F.R. Impact of highly active antiretroviral therapy on the prevalence of oral lesions in HIV-positive patients: a systematic review and meta-analysis.Int J Oral Maxillofac Surg. 2017;46(11):1497-1504. DOI: 10.1016/j.ijom.2017.06.008.Kreuter A., Wieland U. Oral hairy leukoplakia: a clinical indicator of immunosuppression. CMAJ. 2011;183(8):932.Kreuter A., Wieland U. Oral hairy leukoplakia: a clinical indicator of immunosuppression. CMAJ. 2011;183(8):932.Hall L.D., Eminger L.A., Hesterman K.S., Heymann W.R. Epstein-Barr virus: dermatologic associations and implications: part I. Mucocutaneous manifestations of Epstein-Barr virus and nonmalignant disorders. J Am Acad Dermatol. 2015;72(1):19-20. DOI: 10.1016/j.jaad.2014.07.034.Hall L.D., Eminger L.A., Hesterman K.S., Heymann W.R. Epstein-Barr virus: dermatologic associations and implications: part I. Mucocutaneous manifestations of Epstein-Barr virus and nonmalignant disorders. J Am Acad Dermatol. 2015;72(1):19-20. DOI: 10.1016/j.jaad.2014.07.034.Потекаев Н.С., Потекаев С.Н., Потекаев Н.Н., Жукова О.В. Волосатая лейкоплакия как маркер ВИЧ-инфекции и СПИДа. Клиническая дерматология и венерология. 2018;17(4):114-118. DOI: 10.17116/klinderma201817041114. EDN: YLTJSP.Potekaev N.S., Potekaev S.N., Potekaev N.N., ZHukova O.V. Hairy leukoplakia as a marker of HIV infection and AIDS. Klinicheskaya dermatologiya I venerologiya. 2018;17(4):114-118 (in Russ.). DOI: 10.17116/klinderma201817041114. EDN: YLTJSP.Pham P., Shah M. The Bartlett Pocket Guide to HIV/AIDS Treatment 2021. Ppham and Jbriggs LLC. The United States of America. 2021. 81 p.Pham P., Shah M. The Bartlett Pocket Guide to HIV/AIDS Treatment 2021. Ppham and Jbriggs LLC. The United States of America. 2021. 81 p.Crosetti E., Succo G. Non-human immunodeficiency virus-related Kaposi's sarcoma of the oropharynx: a case report and review of the literature. J Med Case Rep. 2013;7:293. DOI: 10.1186/1752-1947-7-293.Crosetti E., Succo G. Non-human immunodeficiency virus-related Kaposi's sarcoma of the oropharynx: a case report and review of the literature. J Med Case Rep. 2013;7:293. DOI: 10.1186/1752-1947-7-293.Общероссийская общественная организация «Российское общество дерматовенерологов и косметологов». Федеральные клинические рекомендации по ведению больных саркомой Капоши. Москва, 2015. 7 с.All-Russian public organization "Russian Society of Dermatovenerologists and Cosmetologists". Federal clinical guidelines for the management of patients with Kaposi's sarcoma. Moscow, 2015. 7 p. (in Russ.)Reid E., Suneja G., Ambinder R.F., Ard K., Baiocchi R., Barta S.K., Carchman E., Cohen A., et al. AIDS-related Kaposi sarcoma, version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2019;17(2):171-189. DOI: 10.6004/jnccn.2019.0008.Reid E., Suneja G., Ambinder R.F., Ard K., Baiocchi R., Barta S.K., Carchman E., Cohen A., et al. AIDS-related Kaposi sarcoma, version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2019;17(2):171-189. DOI: 10.6004/jnccn.2019.0008.Sousa R.H., Souza L.L., Guedes P.T., Prado-Ribeiro A.C., Rodrigues-Oliveira L., Brandão T.B., Alves B.W., Lopes M.A., et al. Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio. Med Oral Patol Oral Cir Bucal. 2021;26(6):e748-e753. DOI: 10.4317/medoral.24708.Sousa R.H., Souza L.L., Guedes P.T., Prado-Ribeiro A.C., Rodrigues-Oliveira L., Brandão T.B., Alves B.W., Lopes M.A., et al. Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio. Med Oral Patol Oral Cir Bucal. 2021;26(6):e748-e753. DOI: 10.4317/medoral.24708.Dubrow R., Qin L., Lin H., Hernández-Ramírez R.U., Neugebauer R.S., Leyden W., Althoff K.N., Achenbach C.J., et al. North American AIDS cohort collaboration on research and design of the international epidemiologic databases to evaluate AIDS. Association of CD4+ T-cell count, HIV-1 RNA viral load, and antiretroviral therapy with Kaposi sarcoma risk among HIV-infected persons in the United States and Canada. J Acquir Immune Defic Syndr. 2017;75(4):382-390. DOI: 10.1097/QAI.0000000000001394.Dubrow R., Qin L., Lin H., Hernández-Ramírez R.U., Neugebauer R.S., Leyden W., Althoff K.N., Achenbach C.J., et al. North American AIDS cohort collaboration on research and design of the international epidemiologic databases to evaluate AIDS. Association of CD4+ T-cell count, HIV-1 RNA viral load, and antiretroviral therapy with Kaposi sarcoma risk among HIV-infected persons in the United States and Canada. J Acquir Immune Defic Syndr. 2017;75(4):382-390. DOI: 10.1097/QAI.0000000000001394.Poizot-Martin I., Lions C., Antoine C., Rey D., Duvivier C., Jacomet C., Allavena C., Huleux T., et al. Kaposi sarcoma in people living with HIV: incidence and associated factors in a French cohort between 2010 and 2015. Wolters Kluwer Health. 2020;34(4):569-577. DOI: 10.1097/QAD.0000000000002450.Poizot-Martin I., Lions C., Antoine C., Rey D., Duvivier C., Jacomet C., Allavena C., Huleux T., et al. Kaposi sarcoma in people living with HIV: incidence and associated factors in a French cohort between 2010 and 2015. Wolters Kluwer Health. 2020;34(4):569-577. DOI: 10.1097/QAD.0000000000002450.Caby F., Guiguet M., Weiss L., Winston A., Miro J.M., Konopnicki D., LeMoing V., Bonnet F., et al. CD4/CD8 ratio and the risk of Kaposi sarcoma or non-hodgkin lymphoma in the context of efficiently treated human immunodeficiency virus (HIV) infection: a collaborative analysis of 20 european cohort studies. Clin Infect Dis. 2021;73(1):50-59. DOI: 10.1093/cid/ciaa1137.Caby F., Guiguet M., Weiss L., Winston A., Miro J.M., Konopnicki D., LeMoing V., Bonnet F., et al. CD4/CD8 ratio and the risk of Kaposi sarcoma or non-hodgkin lymphoma in the context of efficiently treated human immunodeficiency virus (HIV) infection: a collaborative analysis of 20 european cohort studies. Clin Infect Dis. 2021;73(1):50-59. DOI: 10.1093/cid/ciaa1137.Uchoa D.C., Pontes F.S., Souza L.L., Santos G.S., Prado-Ribeiro A.C., Brandao T.B., Oliveira L.R., Gomes C.C., et al. HIV-related non-Hodgkin lymphomas affecting the oral cavity: a clinicopathologic study of 11 cases. Med Oral Patol Oral Cir Bucal. 2022;27(2):e99-e105. DOI: 10.4317/medoral.24993.Uchoa D.C., Pontes F.S., Souza L.L., Santos G.S., Prado-Ribeiro A.C., Brandao T.B., Oliveira L.R., Gomes C.C., et al. HIV-related non-Hodgkin lymphomas affecting the oral cavity: a clinicopathologic study of 11 cases. Med Oral Patol Oral Cir Bucal. 2022;27(2):e99-e105. DOI: 10.4317/medoral.24993.Corti M., Villafañe M.F., Solari R., De Carolis L., Cangelosi D., Santoro J., Schtirbu R., Lewi D., et al. Non-Hodgkin lymphomas of the oral cavity in AIDS patients in a reference hospital of infectious diseases in Argentina: report of eleven cases and review of the literature. J Gastrointest Cancer. 2011;42(3):143-148. DOI: 10.1007/s12029-010-9173-9.Corti M., Villafañe M.F., Solari R., De Carolis L., Cangelosi D., Santoro J., Schtirbu R., Lewi D., et al. Non-Hodgkin lymphomas of the oral cavity in AIDS patients in a reference hospital of infectious diseases in Argentina: report of eleven cases and review of the literature. J Gastrointest Cancer. 2011;42(3):143-148. DOI: 10.1007/s12029-010-9173-9.Шостакович-Корецкая Л.Р., Литвин К.Ю., Кушнерова Е.А., Белоконь А.А., Лесничая А.А., Маргитич И.Н. Течение ассоциированных с вирусом Эпштейна-Барр неходжкинских лимфом у пациентов с ВИЧ при разных вариантах терапевтической тактики: клинические случаи. Клиническая инфектология и паразитология. 2018;7(4):508-517. EDN: POOWOU.SHostakovich-Koreckaya L.R., Litvin K.YU., Kushnerova E.A., Belokon' A.A., Lesnichaya A.A., Margitich I.N. Thecourse of Epstein-Barrne Hodgkin's lymphoma associated patients with HIV with different therapeutic tactics: clinical cases. Klinicheskaya infektologiya i parazitologiya. 2018;7(4):508-517 (in Russ.). EDN: POOWOU.Malek R., Gharibi A., Khlil N., Kissa J. Necrotizing ulcerative gingivitis. Contemp Clin Dent. 2017;8(3):496-500. DOI: 10.4103/ccd.ccd_1181_16.Malek R., Gharibi A., Khlil N., Kissa J. Necrotizing ulcerative gingivitis. Contemp Clin Dent. 2017;8(3):496-500. DOI: 10.4103/ccd.ccd_1181_16.Ravi J.R., Rao T.R. Estimation of prevalence of periodontal disease and oral lesions and their relation to CD4 counts in HIV seropositive patients on antiretroviral therapy regimen reporting at District General Hospital, Raichur. J Indian Soc Periodontol. 2015;19(4):435-439. DOI: 10.4103/0972-124X.156886.Ravi J.R., Rao T.R. Estimation of prevalence of periodontal disease and oral lesions and their relation to CD4 counts in HIV seropositive patients on antiretroviral therapy regimen reporting at District General Hospital, Raichur. J Indian Soc Periodontol. 2015;19(4):435-439. DOI: 10.4103/0972-124X.156886.Sontakke S.A., Umarji H.R., Karjodkar F.Comparison of oral manifestations with CD4 count in HIV-infected patients. Indian J Dent Res. 2011;22(5):732. DOI: 10.4103/0970-9290.93470.Sontakke S.A., Umarji H.R., Karjodkar F.Comparison of oral manifestations with CD4 count in HIV-infected patients. Indian J Dent Res. 2011;22(5):732. DOI: 10.4103/0970-9290.93470.Bravo I.M., Correnti M., Escalona L., Perrone M., Brito A., Tovar V., Rivera H. Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population. Med Oral J. 2009;11(1):E33-39.Bravo I.M., Correnti M., Escalona L., Perrone M., Brito A., Tovar V., Rivera H. Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population. Med Oral J. 2009;11(1):E33-39.Lomelí-Martínez S.M., González-Hernández L.A., Ruiz-Anaya A., Lomelí-Martínez M.A., Martínez-Salazar S.Y., Mercado González A. E., Andrade-Villanueva J.F., Varela-Hernández J.J. Oral manifestations associated with HIV/AIDS patients. Medicina. 2022;58:1214-1218. DOI: 10.3390/medicina58091214.Lomelí-Martínez S.M., González-Hernández L.A., Ruiz-Anaya A., Lomelí-Martínez M.A., Martínez-Salazar S.Y., Mercado González A. E., Andrade-Villanueva J.F., Varela-Hernández J.J. Oral manifestations associated with HIV/AIDS patients. Medicina. 2022;58:1214-1218. DOI: 10.3390/medicina58091214.Fonseca R.R., Carvalho C.A., Rodrigues T.M.S., Cavaleiro R.M.S., Menezes S.A.F., Machado L.F.A. Severe necrotizing periodontitis in an HIV-Infected patient: case report and non-surgical treatment. Clin Adv Periodontics. 2021;11(2):59-63. DOI: 10.1002/cap.10105.Fonseca R.R., Carvalho C.A., Rodrigues T.M.S., Cavaleiro R.M.S., Menezes S.A.F., Machado L.F.A. Severe necrotizing periodontitis in an HIV-Infected patient: case report and non-surgical treatment. Clin Adv Periodontics. 2021;11(2):59-63. DOI: 10.1002/cap.10105.Hu J., Kent P., Lennon J.M., Logan L.K. Acute necrotising ulcerative gingivitis in an immunocompromised young adult. BMJ Case Rep. 2015;20(3):147-150. DOI: 10.1136/bcr-2015-211092.Hu J., Kent P., Lennon J.M., Logan L.K. Acute necrotising ulcerative gingivitis in an immunocompromised young adult. BMJ Case Rep. 2015;20(3):147-150. DOI: 10.1136/bcr-2015-211092.Kato H., Imamura A. Unexpected acute necrotizing ulcerative gingivitis in a well-controlled HIV-infected case.Intern Med. 2017;56(16):2223-2227. DOI: 10.2169/internalmedicine.8409-16.Kato H., Imamura A. Unexpected acute necrotizing ulcerative gingivitis in a well-controlled HIV-infected case.Intern Med. 2017;56(16):2223-2227. DOI: 10.2169/internalmedicine.8409-16.Есаян Л.К., Азатян В.Ю. Изучение распространенности поражения твердых тканей зубов и пародонта у больных с ВИЧ-инфекцией. Проблемы стоматологии. 2018;14(3):17-21. DOI: 10.18481/2077-7566-2018-14-3-17-21. EDN: YOGTTF.Esayan L.K., Azatyan V.Yu. The study of the prevalence of damage to hard tissues of teeth and periodontal disease in patients with HIV infection. Problemy stomatologii. 2018;14(3):17-21 (in Russ.). DOI: 10.18481/2077-7566-2018-14-3-17-21. EDN: YOGTTF.Еленская Ю.Р., Сахарук Н.А., Гречиха А.С. ВИЧ-инфекция: проявление в ротовой полости и ее профилактика. Стоматология. Эстетика. Инновации. 2019;3(1):67-75. EDN: ZSKCVG.YelenskayaYu.R., Sakharuk N.A., Grechikha A.S. HIV infection: manifestation in the oral cavity and its prevention. Stomatologiya. Estetika. Innovacii. 2019;3(1):67-75 (in Russ.). EDN: ZSKCVG.Mwau M., Danda J., Mbugua J., Handa A., Fortunko J., Worlock A., Nair S.V. Prospective evaluation of accuracy of HIV viral load monitoring using the Aptima HIV Quant Dx assay with fingerstick and venous dried blood spots prepared under field conditions in Kenya. PLoS One. 2021;16(4):e0249376. DOI: 10.1371/journal.pone.0249376.Mwau M., Danda J., Mbugua J., Handa A., Fortunko J., Worlock A., Nair S.V. Prospective evaluation of accuracy of HIV viral load monitoring using the Aptima HIV Quant Dx assay with fingerstick and venous dried blood spots prepared under field conditions in Kenya. PLoS One. 2021;16(4):e0249376. DOI: 10.1371/journal.pone.0249376.Mapangisana T., Machekano R., Kouamou V., Maposhere C., McCarty K., Mudzana M., Munyati S., Mutsvangwa J., et al. Viral load care of HIV-1 infected children and adolescents: a longitudinal study in rural Zimbabwe. PLoS One. 2021;16(1):e0245085. DOI: 10.1371/journal.pone.0245085.Mapangisana T., Machekano R., Kouamou V., Maposhere C., McCarty K., Mudzana M., Munyati S., Mutsvangwa J., et al. Viral load care of HIV-1 infected children and adolescents: a longitudinal study in rural Zimbabwe. PLoS One. 2021;16(1):e0245085. DOI: 10.1371/journal.pone.0245085.

The authors declare that there are no conflicts of interest present.