Tratamento e fatores predisponentes da leucoplasia pilosa bucal (LPB) em pacientes potadores de HIV/AIDS atendidos no Centro de Treinamento e Referência em Doenças Infecciosas e Parasitárias Orestes Diniz (CTR/DIP)

Abstract

A study of open clinical trial was performed in order to evaluate and compare the topical treatment of oral hairy leukoplakia with podophyllin resin 25% solution and podophyllin resin 25% solution in association with acyclovir 5%. A case-control study was also performed in order to evaluate factors which predispose to this lesion. For this purpose, 111 HIV-infected patients were selected, being 32 with oral hairy leukoplakia and 79 without oral hairy leukoplakia, treated at Orestes Dinizs Treatment Center of Parasitic and Infectious Diseases, in Belo Horizonte/Minas Gerais. The comparison of the performance of both therapeutic modalities used were evaluated from the number of applications needed to the clinical resolution of the oral hairy leukoplakia, from the correlation and association of the lesions size with the number of applications, from the clinical resolution of oral hairy leukoplakia, and from clinical evaluation three months after the end of the treatment. The predisposing factors evaluated were CD4 T lymphocytes count, viral load, plaques, highly active antiretroviral therapy, gender, salivary flow, xerostomia or dry month, oral candidosis, use of fluconazole, use of systemic acyclovir, use of zidovudine, injecting drug use, smoking and alcohol consumption. The results of this study showed that both modalities of treatment were statistically significant as of the number of applications needed to the clinical resolution of the oral hairy leukoplakia and there was no difference as of the recurrence rate within a period of three months after the end of the treatment. The association of podophyllin resin 25% solution in association with acyclovir 5% had a faster action in the decreasing of the oral hairy leukoplakia size when compared to the isolated use of podophyllin resin 25% solution, and promoted clinical resolution of the oral hairy leukoplakia in 100% of the cases, which did not happen in the group treated only with podophyllin resin 25% solution. In the case-control study it was verified a statistically significant association between the presence of oral hairy leukoplakia and viral load, not use of highly active antiretroviral therapy, presence of oral candidosis, previous use of fluconazole and previous use of systemic acyclovir.