Summary Highly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy.

Palabras clave: Tratamiento anti-retroviral de alta actividad; candidiasis oral; niños; VIH

This study evaluates the antimicrobial efficacy of chitosan nanoparticles (CNPs), varying in size, against clinical isolates of Mycobacterium tuberculosis (MTB), E. coli, S. aureus, E. faecalis, and C. albicans, as well as the antimicrobial effects of aqueous extracts and lyophilized powders of Allium (garlic) species. CNPs were synthesized through ionotropic gelation and characterized by Z potential, hydrodynamic diameter (dynamic light scattering, DLS), and SEM. Aqueous garlic extracts were prepared via decoction. We assessed antimicrobial activity using disk diffusion and broth microdilution methods; in addition, a modified agar proportion method in blood agar was used for antimicrobial activity against MTB. CNPs inhibited MTB growth at 300 μg for 116.6 nm particles and 400 μg for 364.4 nm particles. The highest antimicrobial activity was observed against E. faecalis with nanoparticles between 200 and 280 nm. Allium sativum extract produced inhibition for C. albicans at 100 μg. The results indicate that CNPs possess significant antimicrobial properties against a range of pathogens, including MTB, at high concentrations. On the other hand, aqueous Allium sativum extracts exhibited antimicrobial activity. Nonetheless, due to their instability in solution, the use of lyophilized Allium sativum powder is preferable.

Approximately 39 million people worldwide live with human immunodeficiency virus (HIV), and antiretroviral therapy (ART) has improved life expectancy for these individuals, with quality of life (QoL) being a crucial aspect. However, there is limited information on oral health-related quality of life (OHRQoL) for institutionalized patients with HIV. This study used a cross-sectional design and included 43 residents of a non-governmental institution who had a confirmed HIV diagnosis and a history of intravenous drug use. The Spanish version of the Oral Health Index Profile-14 (OHIPsp) was used to assess the OHRQoL, with the 50th percentile serving as the cutoff for good or poor quality of life. All 43 patients had one or more oral lesions, with 44.1% having AIDS-related oral lesions (AROLs). Over half of the participants (48.8%) reported a poor OHRQoL, and females experienced worse quality of life in all dimensions compared to males. Subjects with AROLs were three times more likely to have poor OHRQoL than those without AROLs (p = 0.03; OR = 3.1 _{IC 1.04–9.6}). These results highlight the need for a comprehensive treatment plan for patients with HIV that includes oral health, particularly for women living in precarious conditions or who are institutionalized. Improving oral health can significantly enhance quality of life.

Las películas de complejos de polielectrólitos pueden ser un vehículo para liberación controlada de fármacos en la cavidad oral, buscando la interacción de la película con el epitelio de la mucosa bucal, dado que con el fenómeno de bioadhesión se logra la retención del sistema en el sitio deseado para la liberación. En el presente trabajo se desarrolló un sistema de liberación usando polímeros polielectrólitos de carga opuesta que forman películas por complejación iónica. Las películas fueron cargadas con diacetato de clorhexidina para el tratamiento de infecciones bucales. Se empleó el método evaporación de solvente para la preparación de las películas, conteniendo goma arábiga y quitosano (1:1) y Noveon AA-1® 2% (p/v), este último se incluyó por sus propiedades mucoadhesivas. Se prepararon películas con las mismas proporciones de polímeros, pero agregando diacetato de clorhexidina disuelto en etanol 2% w/v, previo a la evaporación del disolvente para la formación de las películas. Los estudios de hinchamiento muestran que las películas se hinchan en soluciones que simulan las condiciones de pH bucal. Las películas cargadas con el fármaco liberan in vitro, más del 90 % del fármaco en 24 horas. Las pruebas microbiológicas mostraron que las películas cargadas con diacetato de clorhexidina inhiben el crecimiento E. coli y P. aeruginosa, en las pruebas de sensibilidad estandarizadas. Las películas estudiadas muestran características adecuadas para la liberación de diacetato de clorhexidina, demostrando la inhibición del crecimiento de microrganismos patógenos por lo que tiene potencial para utilizarse en el tratamiento de pacientes con infecciones bucales tales como gingivitis y enfermedad periodontal.