Effect of highly active antiretroviral therapy use on oral manifestations in pediatric patients infected with HIV

Background: The number of pediatric patients affected by HIV still remains high, mainly in developing countries, where the main cause of infection is vertical transmission from the mother. Even today, a large number of these children do not have access to treatment, and, without proper care, they die in the first few years of life. Objective: The aim of our review was to assess the prevalence of oral hard and soft tissue lesions in HIV-positive pediatric patients by identifying the most common manifestations and the overall impact that they may have on the children’s quality of life. Study design: A systematic review of the articles in the English language in PubMed and Scopus was conducted in March 2019 in order to identify the main epidemiological and cross-sectional studies on the topic. Results: Oral diseases are still one of the most common manifestations in HIV-positive pediatric patients, and they often represent the first form in which immunosuppression shows itself. An analysis of the literature shows that candidiasis is the most common oral lesion found in HIV-positive children. A significant incidence of gingivitis and gingival disease is also evident, though not strictly correlated to HIV infection. However, thanks to the introduction of new antiretroviral therapies, the incidence of HIV-related oral lesions is decreasing. Conclusions: An HIV-positive children care program should also include dental protocols, as oral disease negatively influences the quality of life, affecting both functional and social aspects.

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“…Additionally, Oliscovicz et al (2015) showed that 65.8% of the HIV-positive children that were included in the study had already developed AIDS.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

Oral Manifestations in HIV-Positive Children: A Systematic Review

et al. 2020

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“…El análisis de asociación no mostró diferencias significativas entre las especies aisladas y los factores estudiados (p > 0,05), edad, género, estado inmunológico, manifestaciones orales, estadio clínico o terapia ARV 22,23 . Cabe señalar que todos los varones de esta población tuvieron especies colonizantes (p = 0,007), mientras que la probabilidad de tener un caso de candidiasis fue más alta en las mujeres (OR: 17,27; IC 95% 1,81-+Inf).…”

Section: Artículo Originalunclassified

“…VIH / SIDA años o menos con terapia ARV y se encontraban bajo un esquema TARAA de primera línea. El tiempo de terapia es un factor que influye en las manifestaciones orales de sujetos con TARAA, en específico cuando el esquema incluye a un INNTR 22 . En los resultados de este estudio se observó una alta posibilidad de tener manifestaciones orales en esquemas de primera línea con INNTR (OR: 23,56; IC 95% 2,35-1.259,19), aunque en tratamientos de primera línea con IP se observó un efecto protector (OR: 0,14; IC 95% 0,01-0,94) 4 .…”

Section: Artículo Originalunclassified

Factores relacionados a candidiasis oral en niños y adolescentes con VIH, caracterización de especies y susceptibilidad antifúngica

Castillo-Martínez

Mouriño-Pérez

Cornejo-Bravo

et al. 2018

Rev. chil. infectol.

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Factors related to oral candidiasis in HIV children and adolescents, species characterization and antifungal susceptibility Background: Factors associated with candidiasis and colonization in HIV-positive children and adolescents in developing countries are not well understood. Aim: To identify the factors associated with oral Candida colonization and candidiasis in institutionalized HIV-positive children and adolescents in Tijuana, México, as well as the response of the isolates to antifungals. Materials and Methods: Sample of the oral mucosa of 30 HIV positive children and adolescents were obtained to isolate and identify Candida species by culture and metabolic profile. Antifungal drugs susceptibility was determined according to CLSI. Indicators of immunological and virologic failure were classified in accordance to WHO criteria. Results: Six Candida species were identified from oral mucosa, 53% colonizers and 47% in candidiasis. Factors associated with candidiasis and oral colonization were viral load (p = 0,001), CD4+ counts (p = 0,002) and HAART regimen (p ≤ 0,014). The most prevalent species was C. glabrata (33%), but C. albicans (27%) was more resistant to fluconazole (p = 0,001). Itraconazol resistant species were identified in regimens that include an NNRTI (p = 0,041). Conclusion: HIV-positive children and adolescents living in an orphanage showed high prevalence of colonizing Candida spp. and resistance to antifungals, related to NNRTI.

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“…Among the 4,057 individuals, 468 (11.53%) did not receive HAART or ART. The data from 11 articles (28,33,43,44,48,49,(51)(52)(53)(54)56) demonstrated that HAART or ART were significantly associated with reduction in oral Candida colonization or infection, while others showed the opposite relationship (12,16,32,34,41,42,55), or did not report any statistical data (11, 14, 26, 35-40, 47, 50).…”

Section: Resultsmentioning

confidence: 99%

The Prevalence, Etiological Agents, Clinical Features, Treatment, and Diagnosis of HIV-Associated Oral Candidiasis in Pediatrics Across the World: A Systematic Review and Meta-Analysis

et al. 2021

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In HIV-infected pediatrics, oral candidiasis (OC) is a global issue of concern due to its association with dysphagia, malnutrition, and mortality. The present systematic review and meta-analysis are the first to determine the prevalence of OC in HIV-infected pediatrics worldwide. We searched international (PubMed, Web of Science, Scopus, and Embase) databases for studies published between January 2000 to May 2020 reporting the epidemiologic features of OC in HIV-infected pediatrics. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA guidelines. The results of the meta-analysis were visualized as a forest plot. Heterogeneity was also analyzed using the I2, and τ2 statistics. The publication bias was evaluated using Egger test. The literature search revealed 1926 studies, of which 34 studies met the eligibility criteria, consisting of 4,474 HIV-infected pediatrics from 12 different countries. The overall prevalence of OC among HIV-infected pediatrics was 23.9% (95% CI 17.3–32.0%), and Candida albicans was the most prevalent etiologic agent. Pseudomembranous candidiasis was the predominant clinical manifestation in HIV-infected pediatrics suffering from OC. Thirty articles involving 4,051 individuals provided data on HIV treatment status. Among the 4,051 individuals, 468 (11.53%) did not receive HIV treatment. The data from 11 articles demonstrated that HIV treatment was significantly associated with a reduction in oral Candida colonization or infection. In contrast, others showed the opposite relationship or did not report any statistical data. A high level of I2 (I2 = 96%, P < 0.01) and τ2 (τ2 = 1.36, P < 0.01) was obtained among studies, which provides evidence of notable heterogeneity between studies. OC is approximately frequent in HIV-positive children. Therefore, efforts should be made to teach dental and non-dental clinicians who care for HIV-infected pediatrics to diagnose and treat this infection.

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Effect of highly active antiretroviral therapy use on oral manifestations in pediatric patients infected with HIV

Abstract: Although the prevalence of oral lesions was similar between the groups, it was less in patients without AIDS and those under HAART. The duration of HAART usage had a significant influence on the prevalence of these lesions.

Cited by 13 publications

References 1 publication

Oral Manifestations in HIV-Positive Children: A Systematic Review

Oral Manifestations in HIV-Positive Children: A Systematic Review

Factores relacionados a candidiasis oral en niños y adolescentes con VIH, caracterización de especies y susceptibilidad antifúngica

The Prevalence, Etiological Agents, Clinical Features, Treatment, and Diagnosis of HIV-Associated Oral Candidiasis in Pediatrics Across the World: A Systematic Review and Meta-Analysis

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