Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda

Abstract

The aim of this study was to assess the orofacial manifestations and their influence on oral function in human immunodeficiency virus (HIV) positive children attending Mildmay Clinic in Uganda. This was a cross-sectional study based on clinical examination, medical records and a structured questionnaire of 368 children aged between 1.5 and 17 years. The clinical examination for dental caries was based on decayed, extracted and filled teeth (deft) and decayed, missing and filled teeth (DMFT) indices as defined by World Health Organisation. The soft tissue orofacial lesions were assessed using the classification and diagnostic criteria as described by the Collaborative Workgroup on the Oral Manifestations of Pediatric HIV Infections. Approximately 67.4% of the children were on highly active antiretroviral therapy (HAART). The majority (77.4%) of the children had at least one orofacial lesion associated with HIV, pseudomembranous candidiasis being the most prevalent. Overall, 61.7% of the children with orofacial lesions reported at least one form of discomfort in the mouth. Discomfort was particularly associated with swallowing. The prevalence of orofacial lesions was significantly higher in children with poor oral hygiene and lower in those on HAART than in their respective counterparts. The CD4+ cell count, age and gender of the children did not significantly influence the distribution of orofacial lesions. The mean deft and DMFT scores were 11.8 and 2.7, respectively. The d- and D-components contributed 54.7 and 42.1%, respectively. Consumption of sugary snacks was directly associated with dental caries. Despite these children attending an HIV care centre of excellence, they have a high prevalence of orofacial manifestations associated with HIV. The majority of the children experienced discomfort in the oral cavity, particularly during swallowing.

HIV‐associated salivary gland disease – clinical or imaging diagnosis?

“…The prevalence of HIV/SGD in HIV‐infected children in this study was 57.75%, being higher than in other studies in which the prevalence ranged from 11.5%, 12 2%, 19.6% to 25%. It should be noted that in the works by Aguiar Ribeiro et al .…”

“…It is asymptomatic and spontaneously resolves and recurs, being characterised by a diffuse soft‐tissue oedema with unilateral or bilateral parotid gland involvement causing facial disfigurement. It has a prevalence ranging from 11.5%, 12.2%, 19.6% to 25% in HIV‐infected children.…”

Prevalência de manifestações bucais em crianças infectadas pelo HIV: uma revisão da literatura

“…These oral lesions deserve special attention because they are accompanied by considerable pain and interfere in normal feeding. 13,21 Among the periodontal alterations, linear gingival erythema is quite frequent in HIV-positive adults and children. It was reported in 4 out of the 11 selected studies and was the third most common oral lesion in the present literature review.…”

“…[6][7][8][9][10][11][12][13][14][15][16] Its diagnosis is difficult due to the presence of the maternal anti-HIV antibody that crosses the placental barrier and may be detectable in children up to 18 months of age. 6,17 After virus infection, patients can spend several years without manifesting the disease.…”

“…Necrotizing gingivitis was reported in two African studies. 9,13 One of them 9 was conducted with children not exposed to antiretroviral therapy and only one child had necrotizing gingivitis. In the other study, 13 with children exposed and not to antiretroviral therapy, 15 (4.1%) out 368 children had necrotizing gingivitis.…”