Oral lesions among HIV‐infected children on antiretroviral treatment in West Africa

Abstract

Objectives To estimate the prevalence of oral mucosal diseases and dental caries among HIV-infected children receiving antiretroviral treatment (ART) in West Africa, and to identify factors associated with the prevalence of oral mucosal lesions. Methods Multi-center cross-sectional survey in 5 pediatric HIV clinics in Côte d’Ivoire, Mali and Sénégal. A standardized examination was performed by trained dentists on a random sample of HIV-infected children aged 5 to 15 years receiving ART. The prevalence of oral and dental lesions and mean number of decayed, missing/extracted and filled teeth (DMFdefT) in temporary and permanent dentition were estimated with their 95% confidence interval (95%CI). We used logistic regression to explore the association between children’s characteristics and the prevalence of oral mucosal lesions, expressed as prevalence odds ratio (POR). Results The median age of the 420 children (47% females) enrolled was 10.4 years (interquartile range [IQR]=8.3–12.6). The median duration on ART was 4.6 years (IQR=2.6–6.2); 84 (20.0%) had CD4 count<350 cells/mm3. 35 children (8.3%; 95%CI: [6.1–11.1]) exhibited 42 oral mucosal lesions (24 were candidiasis); 86.0% (95%CI=82.6–89.3) of children had DMFdefT≥1. The presence of oral mucosal lesions was independently associated with CD4 count<350 cells/mm3 (POR=2.96, 95% CI=1.06–4.36) and poor oral hygiene (POR=2.69, 95%CI=1.07–6.76). Conclusions Oral mucosal lesions still occur in HIV-infected African children despite ART, but rarely. However, dental caries were common and severe in this population, reflecting the need to include oral health in the comprehensive care of HIV.

Principais manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapia antirretroviral altamente ativa

“…Corroborating with the affirmative protective action of antiretroviral drugs, Meless et al 19 observed in their study a low prevalence of oral lesions, possibly because all the children in the study were being treated with this type of medication. Jose et al 6 compared patients that used and did not use HAART and observed that those on this medication had oral manifestations with moderate intensity, with a lower occurrence of oral candidiasis.…”

“…Oral candidias is and its pseudomembranous, angular cheilitis, erythematous and oropharyngeal variants were reported in most studies 1,2,16,17,19 . The first three variants have been described as the types known to be associated with HIV infection nowadays 11 .…”

“…The first three variants have been described as the types known to be associated with HIV infection nowadays 11 . Thus, it is possible to affirm that the opportunistic lesion most commonly associated with HIV-infected patients is oral candidiasis and that this finding is fundamental for the early diagnosis of AIDS [1][2][3]10,14,16,18,19 . In addition, this oral manifestation may serve as a marker of disease progression and immunosuppression 2,5,13,15 since its prevalence is related to lower values ofTCD4+ lymphocytes 1 .…”

Oral health status and its impact on the quality of life of children and adolescents living with HIV-1

“…People living with Human Immunodeficiency Virus type 1 (HIV-1) may develop oral and systemic manifestations as a result of the natural history of the disease, which can cause a negative impact of quality of life [2]. In fact, oral lesions are among frequent opportunistic infections that occur in individuals living with HIV-1, with the majority developing some form of stomatological manifestation throughout the course of the infection [3,4]. …”

Avaliação cefalométrica da morfologia craniofacial em crianças e adolescentes HIV positivos

“…Com relação às alterações bucodentais identificadas em pacientes HIV, mesmo na atualidade, a literatura parece primar pela identificação de manifestações bucais oportunistas (Baghirath et al, 2013;Konstantyner et al, 2013;Oladokun et al, 2013;Alves et al, 2014;Meless et al, 2014) e pela saúde bucodental (Buczynski et al, 2011;de Aguiar Ribeiro et al, 2013;Ramos-Gomez, Folayan, 2013;Subramaniam;Kumar, 2014).…”