Background A study undertaken in 1992–1993 identified that HIV‐infected dental patients were substantially disadvantaged with regard to the social impact of their oral disease. The oral pain experienced by HIV‐positive patients prior to the introduction of combination antiretroviral therapy (cART) was attributable to specific features of HIV‐related periodontal disease and other oral manifestations of HIV such as candida infections and xerostomia. A repeat of this study in 2009–2010 provided additional information in the post‐cART era. Methods Data were collected from three sources: the 2009–2010 HIV‐positive sample, the National Survey of Adult Oral Health (NSAOH) and the original 1992–1993 study. Collation of data was by clinical and radiographic oral examination. Information about the social impact of oral conditions was obtained from the Oral Health Impact Profile. Results The caries experience of the 2009–2010 HIV‐positive sample was improved with statistical significance for both mean DMFT and mean DT, while the presence of HIV‐related periodontal disease still occurs. Statistically significant improvements were achieved for prevalence and severity of oral health related quality of life. Conclusions The need for timely access to oral health care with a focus on prevention is essential for HIV‐positive individuals whose health is impacted by chronic disease, smoking and salivary hypofunction.

Background: The introduction of combination antiretroviral therapy (cART) for the treatment of human immunodeficiency virus (HIV) has resulted in changes to the oral health of infected individuals. Little data are available describing prevalence and severity of oral manifestations in a post cART cohort of HIV positive patients. Methods: A retrospective case note analysis was performed at the Special Needs Unit (SNU), Adelaide Dental Hospital with emphasis on identifying the prevalence of HIV related oral manifestations (OM). A total of 498 (474 males: 24 females) HIV positive individuals were identified who had attended SNU for dental care between 2001 and 2008. Results: There were significant differences observed in the prevalence of oral manifestations between cART and non-cART groups, and also in comparison to a previous pilot study. Individuals taking cART therapy tended to present with more evidence of linear gingival erythema, angular cheilitis, human papilloma virus associated squamous papillomas and xerostomia. Conclusions: The widespread adoption of cART in the treatment of HIV has altered the oral health profile of these individuals. These findings provide information on the incidence of oral conditions and demonstrate the need to identify and address oral health needs for people living with HIV.

Background In human immunodeficiency virus (HIV)–positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART. Methods Sixteen cohorts from the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children <18 years at ART initiation, with sustained viral suppression (VS) (≤400 copies/mL) for ≥1 year were included. The prevalence of PIR (defined as World Health Organization advanced/severe immunosuppression for age) at 1 year of VS was described. Factors associated with PIR were assessed using logistic regression. Rates of acquired immunodeficiency syndrome (AIDS) or death on suppressive ART were calculated by PIR status. Results Of 2318 children included, median age was 6.4 years and 68% had advanced/severe immunosuppression at ART initiation. At 1 year of VS, 12% had PIR. In multivariable analysis, PIR was associated with older age and worse immunological stage at ART start, hepatitis B coinfection, and residing in Thailand (all P ≤ .03). Rates of AIDS/death (95% confidence interval) per 100 000 person-years were 1052 (547, 2022) among PIR versus 261 (166, 409) among immune responders; rate ratio of 4.04 (1.83, 8.92; P < .001). Conclusions One in eight children in our cohort experienced PIR despite sustained VS. While the overall rate of AIDS/death was low, children with PIR had a 4-fold increase in risk of event as compared with immune responders.