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Faé DS, de Aquino SN, Verner FS, Lemos CAA. Dental caries in HIV-infected children and adolescents: A systematic review with meta-analysis. Oral Dis 2024; 30:1756-1764. [PMID: 37357361 DOI: 10.1111/odi.14637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/12/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023]
Abstract
This study aimed to evaluate and compare the risk of dental caries in between human immunodeficiency virus (HIV)-infected and uninfected children and adolescents. An electronic search was performed on PubMed/MEDLINE, Web-of-Science, Scopus, LILACS, ProQuest, and ClinicalTrials.gov up to May 2022. The critical appraisal checklist developed by the Joanna Briggs Institute was used to evaluate the quality of the included studies. Meta-analysis was performed using the RevMan 5.4. Sixteen studies were included. A total of 3231 participants were evaluated, including 1701 and 1530 HIV-infected and uninfected children and adolescents, respectively. The meta-analysis revealed a higher risk of dental caries for primary dentitions in HIV-infected children and adolescents by decayed, missing, filled tooth (dmft) (SMD:0.34; p = 0.006) and decayed, missing, filled surface (dmfs) scores (SMD:0.37; p = 0.001). Similar results were observed for permanent dentition, with increased dental caries in HIV-infected children and adolescents with DMFT (SMD:0.32; p = 0.003) and DMFS (SMD:1.78; p < 0.0001) scores. Regarding the quality assessment, most of the included studies were moderate or good quality. However, the certainty of the evidence of the outcomes was very low. This systematic review and meta-analysis showed higher caries severity in permanent and deciduous teeth among HIV-infected children and adolescents.
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Affiliation(s)
- Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Governador Valadares, Brazil
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Mann AE, O'Connell LM, Osagie E, Akhigbe P, Obuekwe O, Omoigberale A, Kelly C, Coker MO, Richards VP. Impact of HIV on the Oral Microbiome of Children Living in Sub-Saharan Africa, Determined by Using an rpoC Gene Fragment Metataxonomic Approach. Microbiol Spectr 2023; 11:e0087123. [PMID: 37428077 PMCID: PMC10434123 DOI: 10.1128/spectrum.00871-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/11/2023] [Indexed: 07/11/2023] Open
Abstract
Children living with HIV have a higher prevalence of oral diseases, including caries, but the mechanisms underlying this higher prevalence are not well understood. Here, we test the hypothesis that HIV infection is associated with a more cariogenic oral microbiome, characterized by an increase in bacteria involved in the pathogenesis of caries. We present data generated from supragingival plaques collected from 484 children representing three exposure groups: (i) children living with HIV (HI), (ii) children who were perinatally exposed but uninfected (HEU), and (iii) unexposed and therefore uninfected children (HUU). We found that the microbiome of HI children is distinct from those of HEU and HUU children and that this distinction is more pronounced in diseased teeth than healthy teeth, suggesting that the impact of HIV is more severe as caries progresses. Moreover, we report both an increase in bacterial diversity and a decrease in community similarity in our older HI cohort compared to our younger HI cohort, which may in part be a prolonged effect of HIV and/or its treatment. Finally, while Streptococcus mutans is often a dominant species in late-stage caries, it tended to be found at lower frequency in our HI cohort than in other groups. Our results highlight the taxonomic diversity of the supragingival plaque microbiome and suggest that broad and increasingly individualistic ecological shifts are responsible for the pathogenesis of caries in children living with HIV, coupled with a diverse and possibly severe impact on known cariogenic taxa that potentially exacerbates caries. IMPORTANCE Since its recognition as a global epidemic in the early 1980s, approximately 84.2 million people have been diagnosed with HIV and 40.1 million people have died from AIDS-related illnesses. The development and increased global availability of antiretroviral treatment (ART) regimens have dramatically reduced the mortality rate of HIV and AIDS, yet approximately 1.5 million new infections were reported in 2021, 51% of which are in sub-Saharan Africa. People living with HIV have a higher prevalence of caries and other chronic oral diseases, the mechanisms of which are not well understood. Here, we used a novel genetic approach to characterize the supragingival plaque microbiome of children living with HIV and compared it to the microbiomes of uninfected and perinatally exposed children to better understand the role of oral bacteria in the etiology of tooth decay in the context of HIV exposure and infection.
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Affiliation(s)
- Allison E. Mann
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| | - Lauren M. O'Connell
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| | - Esosa Osagie
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Paul Akhigbe
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Ozoemene Obuekwe
- University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Colton Kelly
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
- School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - the DOMHaIN Study Team
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
- Institute of Human Virology Nigeria, Abuja, Nigeria
- University of Benin Teaching Hospital, Benin, Edo State, Nigeria
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, New Jersey, USA
- School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Modupe O. Coker
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, New Jersey, USA
| | - Vincent P. Richards
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
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Abdulaziz Alsufyani A. Post-COVID-19 effect on biochemical parameters in children: Should we take heed? Saudi J Biol Sci 2023; 30:103649. [PMID: 37069947 PMCID: PMC10079315 DOI: 10.1016/j.sjbs.2023.103649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 03/16/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
The aim of this research is to analyze the potential impact of the COVID-19 infection on the serum biochemical concentration of children 6 months after recovery from the infection. The study included 72 children with a median age of 11 years. The case group consisted of 37 children who had contracted COVID-19 6 months prior to the analysis. They reported no other pre- or post-covid chronic or systemic diseases. The control group consisted of 35 children who had no prior record of COVID-19 infection. The analysis showed a substantial variation (P = 0.026) in the mean urea values (mmol/L) between the case group (4.513 ± 0.839) and the control group (5.425 ± 1.173). However, both groups' urea levels were within the normal range of their age group. No statistical differences were found analyzing the variations between the two groups in the levels of LDH, AST, ALT, BiliT, GGT, AlbBCG2, CRP, CK, AlKP, UA, Phos, Crea2, Gluc, Ca, Na, K, Cl, TP, TC, TG, and HDL (P > 0.05). The DMFT score was substantially greater (P < 0.002) in the infected team (5.38 ± 2.841) in comparison to the non-infected group (2.6 ± 2.257). The study indicates that COVID-19 infection does not leave biochemical alterations among children who did not have pre-existing conditions. The biochemical analysis suggests that children recover better than adults from COVID-19. Furthermore, it calls for investigating non-lethal COVID-19 infection as a tool to discover underlying conditions. The DMFT score shows a correlation between COVID-19 infection and caries. However, the nature of the correlation is yet to be investigated.
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Affiliation(s)
- Amal Abdulaziz Alsufyani
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
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Costa EMMDB, Maia CMDA, Vasconcelos PGS, Portela MB, Barboza CM, Cardoso AS, de Araújo Soares RM, dos Santos ALS. Influence of oral biofilm index, caries experience, and laboratory markers of disease progression on the oral carriage of Candida in HIV-infected and non-infected children: a cross-sectional study. Braz J Microbiol 2022; 53:1969-1977. [PMID: 36224461 PMCID: PMC9679062 DOI: 10.1007/s42770-022-00843-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 10/03/2022] [Indexed: 01/13/2023] Open
Abstract
The present study aimed to compare the oral Candida rate between infected and uninfected children with the human immunodeficiency virus (HIV), as well as analyze the association between Candida spp. and predisposing factors of colonization, like oral biofilm index, caries experience, and laboratory markers of AIDS progression. A cross-sectional study was employed. Candida species were identified and quantified from saliva samples of 50 HIV-infected and 50 uninfected children. Biofilm index and decayed, missing, and filled teeth (dmft/DMFT) indices were assessed by oral clinical examinations. Additionally, CD4+ T lymphocyte count and viral load were obtained from medical records of the HIV-infected children. Candida species were cultured from 74% of the HIV-infected children and 46% of uninfected ones (p = 0.0076). Candida albicans and Candida parapsilosis were the most frequently isolated species in both studied groups. The isolation of Candida species was significantly higher in HIV-infected children with CD4 ≤ 15% (p = 0.0146); it had influence of mature oral biofilm and the caries index (dmft + DMFT ≥ 8) (p < 0.05) and was associated with the plasma viral load. The present data show that the HIV infection, oral biofilm index, caries experience, and laboratory markers of AIDS progression exert an influence on the prevalence of oral Candida in children.
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Affiliation(s)
| | | | | | - Maristela Barbosa Portela
- Departamento de Odontoclínica e Odontopediatria, Universidade Federal Fluminense, Niterói, RJ Brazil
| | - Caroliny Mello Barboza
- Departamento de Odontoclínica e Odontopediatria, Universidade Federal Fluminense, Niterói, RJ Brazil
| | - Abel Silveira Cardoso
- Departamento de Patologia e Diagnóstico Oral, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - Rosangela Maria de Araújo Soares
- Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
| | - André Luis Souza dos Santos
- Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goés, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ Brazil
- Rede Micologia RJ – Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro, RJ Brazil
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Lam PPY, Zhou N, Wong HM, Yiu CKY. Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12864. [PMID: 36232165 PMCID: PMC9564723 DOI: 10.3390/ijerph191912864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/28/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Antiretroviral therapy (ART) increases the survival of HIV-infected children, but might also bring in oral health-related side effects and increase their risks of oral diseases. The review compared the oral health status of children living with HIV (CLWH) undergoing ART with healthy controls. Dual independent screening and study selection from four electronic databases and manual searches, data extraction, risk of bias assessment, and quality-of-evidence evaluation with Grading of Recommendations Assessment Development and Evaluation were performed. Twelve studies were included in qualitative and quantitative analysis. CLWH taking ART had a significantly higher prevalence of periodontal diseases (OR = 3.11, 95% CI 1.62-5.97), mucosal hyperpigmentation (OR = 20.35, 95% CI 3.86-107.39), and orofacial-related opportunistic infections than healthy controls. No significant differences regarding caries prevalence and tooth development were identified. Those with CD4+ T-cell counts below 250 cells/mm3 were more likely to manifest opportunistic infections, while medication duration had minimal influence on the prevalence of orofacial opportunistic infections. The current findings did not identify HIV and antiretroviral status as predisposing factors to dental caries, but affirmed the associated increased risk of periodontal diseases, mucosal hyperpigmentation and candidiasis.
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Affiliation(s)
- Phoebe Pui Ying Lam
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ni Zhou
- School of Stomatology, Kunming Medical University, Kunming 650032, China
| | - Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Akhigbe P, Chukwumah NM, Folayan MO, Divaris K, Obuekwe O, Omoigberale A, Jedy-Agba E, Kim M, Charurat ME, Richards VP, Coker MO. Age-specific associations with dental caries in HIV-infected, exposed but uninfected and HIV-unexposed uninfected children in Nigeria. BMC Oral Health 2022; 22:429. [PMID: 36167498 PMCID: PMC9512979 DOI: 10.1186/s12903-022-02421-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background HIV infection and its management confer a substantial health burden to affected individuals and have been associated with increased risk of oral and dental diseases. In this study, we sought to quantify HIV-associated differences in the prevalence and severity of dental caries in the primary and permanent dentition of 4–11-year-old Nigerian Children. Methods We used clinical, laboratory, demographic, and behavioral data obtained from an ongoing cohort study of age-matched HIV-infected (HI, n = 181), HIV-exposed-but-uninfected (HEU, n = 177), and HIV-unexposed-and-uninfected (HUU, n = 186) children. Measures of dental caries experience (i.e., prevalence and severity) were based on dmft/DMFT indices recorded by trained and calibrated clinical examiners. Differences in primary and permanent dentition caries experience between HI, HEU, and HUU were estimated using multivariable logistic and negative binomial regression modeling. Results HI children had significantly higher caries experience (33%) compared to HEU (15%) and HUU (22%) children. This difference persisted in fully adjusted analyses [odds ratio (OR) = 1.6; 95% confidence interval (CI) = 1.0–2.6], was most pronounced in the permanent dentition (OR = 3.4; 95% CI = 1.2–9.5), and mirrored differences in caries severity. While molars were predominantly affected in both primary and permanent dentitions, caries lesion patterns differed between dentitions. Caries severity was significantly associated with hypoplastic primary teeth, gingival inflammation, and lower CD4 counts. Conclusions We found that the higher prevalence and severity of dental caries among HI children was driven by increased burden of permanent dentition caries compared to their uninfected counterparts. The dentition-specific associations identified in this study highlight the need to design and implement age-specific caries prevention strategies. These may include intensified oral hygiene regimens aimed at mitigating the cariogenic impact of hyposalivation among HI children. Similarly, the long-lasting impacts of developmental defects of the enamel in the primary and permanent dentitions must not be ignored. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02421-w.
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Affiliation(s)
- Paul Akhigbe
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Nneka M Chukwumah
- Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Ozoemene Obuekwe
- Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin, Edo State, Nigeria.,Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | - Augustine Omoigberale
- Department of Preventive Dentistry, University of Benin Teaching Hospital, Benin, Edo State, Nigeria.,Child Health Department, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Michael Kim
- Department of Oral Biology, School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - Manhattan E Charurat
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MA, USA
| | | | - Modupe O Coker
- Department of Oral Biology, School of Dental Medicine, Rutgers University, Newark, NJ, USA. .,Department of Epidemiology, School of Public Health, Rutgers University, Newark, NJ, USA. .,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
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7
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Lam PPY, Zhou N, Yiu CKY, Wong HM. Impact of Antiretroviral Therapy on Oral Health among Children Living with HIV: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911943. [PMID: 36231240 PMCID: PMC9565507 DOI: 10.3390/ijerph191911943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 05/11/2023]
Abstract
Oral health is an integral component of general health and well-being but might be undermined among children living with HIV (CLWH) due to the condition itself or the antiretroviral therapy (ART) received. This review summarises the current evidence and compares the oral health status of the CLWH who were treatment-naïve with those undergoing different ART medications. Fourteen studies were included in the final qualitative and quantitative analyses. This review identified no significant difference in the prevalence of caries, periodontal conditions, and tooth development between both groups. Orofacial opportunistic infections were more prevalent in the CLWH without ART. Children undergoing ART with a duration longer than 3 years had a significantly lower prevalence of oral candidiasis and CD4+ T-cell counts. However, due to the insufficient number of well-administered case-control studies with adequate sample size, the quality of the evidence in all outcomes was of very low certainty.
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Affiliation(s)
- Phoebe Pui Ying Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ni Zhou
- School of Stomatology, Kunming Medical University, Kunming 650032, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Hai Ming Wong
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
- Correspondence: ; Tel.: +852-2859-0261
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Evaluation of Association of Oral Bacterial Profile with HBV and HCV Infection and T Lymphocyte Level in HIV-Positive Patients. Int J Dent 2022; 2022:8622181. [PMID: 35783688 PMCID: PMC9246570 DOI: 10.1155/2022/8622181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/28/2022] [Indexed: 11/26/2022] Open
Abstract
Background This study was aimed to determine the oral bacterial profile of HIV-positive patients and their correlation with T lymphocyte and CD4 count and hepatitis B and C incidence. Methods In this study, 73 patients who were diagnosed HIV-positive and were referred to Shiraz HIV research center for routine dental treatment were enrolled. Demographic data including sex, ethnicity, CD4+ T cell, and T lymphocyte counts were collected from their medical records. Supragingival dental plaque and samples from the dorsal of the tongue were collected by sterile swabs. These samples were transferred to the microbiology laboratory of Jahrom University of Medical Sciences. After primary biochemical test of cultured samples, assessment of bacterial biofilms was done by DNA extraction. Real-time PCR with specific primer of each bacterial species was done, and assessment of the results of real time PCR led to determination of the species of the evaluated bacteria. The correlation of bacterial prevalence with hepatitis B and C was evaluated by chi-square test. Furthermore, Mann–Whitney test was used to evaluate the association of bacterial species prevalence with CD4 and T lymphocyte level. Results The prevalence of none of the detected bacteria had statistically significant relationship with hepatitis C, except for Peptostreptococcaceae (p value = 0.016) in the tongue plaque and Leptotrichia (p value = 0.022) in dental plaque. None of the evaluated bacteria showed any significant association with CD4 and T lymphocytes level, except for Kingella (p value = 0.025, 0.019, respectively), and also no significant correlation was reported with CD4, except for Gemella (p value = 0.021) and Campylobacter gracilis (p value = 0.029). Conclusions The diversity of the detected bacteria was more in dental plaque, while their density was more noticeable in the tongue plaque. No significant correlation was found between the prevalence of most of the detected bacteria and CD4 level and T lymphocyte level and incidence of hepatitis B and C.
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Birungi N, Fadnes LT, Engebretsen IMS, Tumwine JK, Lie SA, Åstrøm AN. Caries experience by socio-behavioural characteristics in HIV-1-infected and uninfected Ugandan mothers - a multilevel analysis. Acta Odontol Scand 2022; 80:91-98. [PMID: 34176405 DOI: 10.1080/00016357.2021.1942544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess caries experience in Ugandan mothers according to HIV status, socio-behavioural-characteristics, gingival bleeding status and to examine whether HIV status impacts the association of socio-behavioural characteristics with caries experience. Third, using multilevel analysis, this study assessed to what extent surface-specific caries experience varied between and within individuals. MATERIALS AND METHODS Caries experience was recorded using the World Health Organization's Decayed, Missed and Filled Teeth/Surfaces indices from a cohort of 164 HIV-1-infected Ugandan mothers and a cross sectional comparison group of 181 negative controls. Mixed-effects logistic regression was conducted with surface-specific caries experience as the outcome variable. RESULTS The prevalence of caries in HIV-1-infected and uninfected mothers was 81% and 71%, respectively. Significant associations occurred between caries experience at surface level and women's increasing age (odds ratio [OR] = 1.8, 95% confidence interval [CI]: 1.1-2.8) and presence of gingival bleeding (OR = 2.0, 95% CI: 1.2-3.2). Intra-class correlation (ICC) coefficient amounted to 0.54 (95% CI 0.48‒0.59). CONCLUSIONS Caries prevalence was higher in HIV-1 infected than in uninfected mothers and increased with age and gingival bleeding. ICC indicated that 54% of the variance was attributable to variation between individuals. Socio-demographic differences in dental caries did not vary by HIV-1 status.
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Affiliation(s)
- Nancy Birungi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Department of Global Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - James Kashugyera Tumwine
- Department of Paediatrics’ and Child Health, School of Medicine, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Kikuchi K, Yasuoka J, Tuot S, Okawa S, Yem S, Chhoun P, Murayama M, Huot C, Yi S. Dental caries in association with viral load in children living with HIV in Phnom Penh, Cambodia: a cross-sectional study. BMC Oral Health 2021; 21:159. [PMID: 33765997 PMCID: PMC7995569 DOI: 10.1186/s12903-021-01441-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 02/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background Oral health status is associated with the overall health among people living with human immunodeficiency virus (HIV) infection. However, it is unclear whether dental caries is associated with the viral load in this population. Particularly, dental caries among children living with HIV needs better understanding as this can affect their overall health and future well-being. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia. Methods This cross-sectional study, conducted at the National Pediatric Hospital as a baseline survey of a randomized controlled trial, included 328, 3–15-year-old children living with HIV and their primary caregivers. Calibrated and trained examiners conducted oral examinations for dental caries (DMFT/dmft index) in the children and retrieved the latest HIV viral load data from the hospital’s patient information system. On the dental examination day, the children and their caregivers were invited to answer a questionnaire-based interview. Multiple logistic regression analysis was conducted to assess the association between dental caries and viral load. The cut-off point for undetectable viral load was set at < 40 copies/mL. Results Data from 328 children were included in the analysis; 68.3% had an undetectable viral load. The mean DMFT/dmft was 7.7 (standard deviation = 5.0). Adjusted regression analysis showed that dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 1.01–1.14). Conversely, antiretroviral therapy of ≥ 1 year and self-reported better adherence to antiretroviral drugs were negatively associated with detectable viral load. Among children with detectable viral load, dental caries in permanent or deciduous teeth was positively associated with non-suppression of viral load (> 1000 copies/mL) (AOR: 1.12, CI: 1.03–1.23). Conclusions Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that dental caries may affect their immune status. The oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.
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Affiliation(s)
- Kimiyo Kikuchi
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Junko Yasuoka
- Research and Education Center for Prevention of Global Infectious Diseases of Animals, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.,Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sumiyo Okawa
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Sokunthea Yem
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | | | | | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.,Center for Global Health Research, Touro University California, Vallejo, CA, USA.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
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11
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Khoury ZH, Meeks V. The influence of antiretroviral therapy on HIV-related oral manifestations. J Natl Med Assoc 2021; 113:449-456. [PMID: 33762122 DOI: 10.1016/j.jnma.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This review aims to provide primary medical and dental healthcare professionals with the current state of information on the oral manifestations of HIV infection in the era of antiretroviral therapy (ART) advancements. RESULTS Infection with the human immunodeficiency virus (HIV) is associated with an increased risk of infectious, neoplastic, and immune-mediated oral complications that are regarded as a major constituent of this global epidemic. HIV-related oral manifestations have been subject to changes in their prevalence with the employment of ART, particularly in this period of enhanced patient accessibility to ART. Available antiretroviral medications (ARVs), the clinical presentation of common HIV-related oral manifestations, and patients and healthcare providers' perceptions are also discussed. CONCLUSIONS Screening, diagnosing, and treating patients with HIV/Acquired immunodeficiency syndrome (AIDS) has improved drastically since the isolation and characterization of HIV. Oral manifestations have been acknowledged to correlate with treatment responses and disease progression. Healthcare providers should be familiar with HIV-related oral manifestations and comfortable in managing and referring patients with HIV/AIDS, they are also key stakeholders in facilitating the elimination of the stigma associated with the infection.
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Affiliation(s)
- Zaid H Khoury
- Department of Oncology & Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, 650W Baltimore St, 7th Floor North, Baltimore, MD 21201, United States.
| | - Valli Meeks
- Department of Oncology & Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, 650W Baltimore St, 7th Floor North, Baltimore, MD 21201, United States
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12
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Yengopal V, Ayodeji Esan T, Joosab Z. Is there an association between viral load, CD4 count, WHO staging, and dental caries in HIV-positive children? Int J Paediatr Dent 2021; 31:231-237. [PMID: 32419236 DOI: 10.1111/ipd.12663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Few studies have investigated an association between CD4 counts, viral load (VL), WHO staging, and caries among HIV-positive (HIV+) children on HAART therapy (>12 months). AIM To determine the strength of association between CD4 counts, WHO staging, VL, and dental caries. DESIGN This cross-sectional analytical study comprised of 355 HIV + children, aged 4-12 years, attending a hospital in Johannesburg, South Africa. Demographic and clinical data such as decayed (d,D), missing (m,M), filled teeth (f,F) [dmft/DMFT], CD4 counts, and WHO staging were collected. Correlation and regression analyses were done to test for associations. RESULTS Caries prevalence for this cohort of children was 57%. The dmft score for the primary dentition was 4.36 (SD 4.87) and DMFT for secondary dentition was 0.58 (SD 1.49). Pearson's correlation analyses showed significant association between VL and CD4 count (P = .003) and VL and WHO stage (P = .007). Weak associations were noted between caries (d, D) and VL, CD4 count, and WHO stage of disease for correlation and regression analyses. CONCLUSION There appears to be no substantial evidence of any significant association between the presence of caries among HIV + children and CD4 counts, viral load, and WHO clinical stage of the disease.
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Affiliation(s)
- Veerasamy Yengopal
- Department of Community Dentistry, School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Temitope Ayodeji Esan
- Department of Restorative Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.,School of Anatomical Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zorayda Joosab
- Department of Community Dentistry, School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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13
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Immune status, and not HIV infection or exposure, drives the development of the oral microbiota. Sci Rep 2020; 10:10830. [PMID: 32616727 PMCID: PMC7331591 DOI: 10.1038/s41598-020-67487-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/06/2020] [Indexed: 12/13/2022] Open
Abstract
Even with antiretroviral therapy, children born to HIV-infected (HI) mothers are at a higher risk of early-life infections and morbidities including dental disease. The increased risk of dental caries in HI children suggest immune-mediated changes in oral bacterial communities, however, the impact of perinatal HIV exposure on the oral microbiota remains unclear. We hypothesized that the oral microbiota of HI and perinatally HIV-exposed-but-uninfected (HEU) children will significantly differ from HIV-unexposed-and-uninfected (HUU) children. Saliva samples from 286 child-participants in Nigeria, aged ≤ 6 years, were analyzed using 16S rRNA gene sequencing. Perinatal HIV infection was significantly associated with community composition (HI vs. HUU—p = 0.04; HEU vs. HUU—p = 0.11) however, immune status had stronger impacts on bacterial profiles (p < 0.001). We observed age-stratified associations of perinatal HIV exposure on community composition, with HEU children differing from HUU children in early life but HEU children becoming more similar to HUU children with age. Our findings suggest that, regardless of age, HIV infection or exposure, low CD4 levels persistently alter the oral microbiota during this critical developmental period. Data also indicates that, while HIV infection clearly shapes the developing infant oral microbiome, the effect of perinatal exposure (without infection) appears transient.
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Mohamed N, Mathiba OP, Mulder R. Oral status of HIV-infected children aged 12 years or younger who attended a Paediatric Infectious Diseases Clinic in Cape Town. Clin Exp Dent Res 2020; 6:75-81. [PMID: 32067394 PMCID: PMC7025988 DOI: 10.1002/cre2.251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children continue to suffer from the impact of the human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS) pandemic. In Cape Town, these children receive medical care including antiretroviral therapy from facilities like Tygerberg Hospital's Paediatric Infectious Diseases Clinic. HIV-infected children may experience an increased caries experience when compared with their healthy peers. AIM The aim of this study was to determine the oral health status of HIV-infected children younger than 12 years receiving antiviral drugs at the Paediatric Infectious Diseases Clinic. DESIGN A cross-sectional survey was conducted among children aged between 2 and 12 years presenting at this clinic. Caregivers were interviewed to obtain information regarding health seeking behaviour, oral hygiene practices and dietary habits. A single clinician undertook a standardized clinical intraoral examination according to the World Health Organization guidelines, with modifications. RESULTS Sixty-six children were recruited. A high prevalence of dental caries (78.8%) and an unmet treatment need of 90.4% were recorded among the participants. Most children had never visited the dentist, and those who did had mainly received emergency dental care. CONCLUSION The high prevalence of severe dental caries in this population highlights the need for oral health awareness and the inclusion of oral health care in the comprehensive care of children with HIV. WHY THIS PAPER IS IMPORTANT TO PAEDIATRIC DENTISTS The study highlights the importance of collaborating with health professions outside of dentistry. Doctors and nurses are often the first health professionals to come into contact with children with special needs. They should therefore be made aware of the early signs of decay so that these patients can be referred for dental treatment timeously. Holistic management of children with special healthcare needs is essential to improve their overall well-being.
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Affiliation(s)
- Nadia Mohamed
- Department of Paediatric DentistryUniversity of the Western CapeCape TownSouth Africa
| | | | - Riaan Mulder
- Department of Paediatric DentistryUniversity of the Western CapeCape TownSouth Africa
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15
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Malele Kolisa Y, Yengopal V, Shumba K, Igumbor J. The burden of oral conditions among adolescents living with HIV at a clinic in Johannesburg, South Africa. PLoS One 2019; 14:e0222568. [PMID: 31618211 PMCID: PMC6795420 DOI: 10.1371/journal.pone.0222568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 09/03/2019] [Indexed: 01/13/2023] Open
Abstract
Background There are inconsistent reports on the prevalence of oral conditions and their associated factors among adolescents living with HIV (ALHIV). The current inconsistencies may hinder the development of clear guidelines on the prevention and treatment of oral conditions among ALHIV. This study provides an update on oral conditions and their associated factors in a cohort of South African ALHIV and receiving routine HIV treatment services at a Johannesburg HIV wellness clinic. Methods Decayed Teeth (DT), Decayed Missing and Filled Teeth (DMFT) and Oral HIV/AIDS Research Alliance case definitions were used for caries examination and reporting of the Oral Mucosal Lesions (OML) respectively. Data analyses were stratified by the study main outcomes; chi-squared tests were performed to determine the associations; and multiple logistic regressions were also used to identify associated factors after adjusting for other exposure variables. In addition to fitting logistic regressions, we explored the data for potential confounders and effect modifiers. Results A total of 407 ALHIV were assessed, of which 51.0% were females. The mean age of the ALHIV was 14.75 years (SD 2.43) while the median age of their parents was 43 years (IQR 37–48 years). Regardless of sex, age group and other socio-demographic characteristics, participants had high count of dental caries (DMFT>0). The overall prevalence of dental caries was 56.76% (n = 231) with mean DT score of 2.0 (SD 2.48) and mean DMFT score of 2.65 (SD 3.01). Dental caries prevalence (DT>0) was significantly associated with the HIV clinical markers. HIV RNA viral loads more than 1000 copies/ml and CD4 cell counts less than 200 count cells/mm3, increased the likelihood of having dental decay among ALHIV (p<0.05). ALHIV at WHO staging III, IV had higher caries prevalence ranging from 70% to 75% (p<0.05). The prevalence of dental caries was directly related to the presence of oral mucosal lesions (p<0.05). The prevalence of OML was 22%, with linear gingival erythema (13.8%) accounting for most of the OML. Multiple logistic regression modelling suggested that dental caries experience (DMFT>0), age category 13–15 years, WHO staging of IV and viral load of more than 1000 copies/ml significantly predicted the outcome of oral lesions as assessed using the OHARA case definitions (p<0.05). The odds of developing dental caries was also 1.5 times more among ALHIV who brush their teeth less frequently and those who reported more frequent eating of sugar sweetened diets (p<0.05). Conclusions There is high prevalence of dental caries and OML among ALHIV in Johannesburg. The reported prevalence was associated with high HIV RNA viral loads, shorter duration on antiretroviral treatment and high WHO staging of HIV disease on crude analysis. Additionally, caries experience contributed to the prevalence of OML. Our study acknowledges the protective effect of HIV treatment and positive oral health practices on the presence of oral conditions among ALHIV in Johannesburg.
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Affiliation(s)
- Yolanda Malele Kolisa
- School of Oral Health Sciences, Department of Community Dentistry, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Veerasamy Yengopal
- School of Oral Health Sciences, Department of Community Dentistry, University of the Witwatersrand, Johannesburg, South Africa
| | - Khumbo Shumba
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Jude Igumbor
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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16
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Stern J, Miller G, Li X, Saxena D. Virome and bacteriome: two sides of the same coin. Curr Opin Virol 2019; 37:37-43. [PMID: 31177014 PMCID: PMC6768692 DOI: 10.1016/j.coviro.2019.05.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 12/17/2022]
Abstract
Although bacterial dysbiosis has been previously associated with carcinogenesis and HIV infection, the impact of the virome and these disease states has been less well studied. In this review, we will summarize what is known about the interplay between both the bacterial and the viral components of the microbiome on cancer and HIV pathogenesis. Bacterial dysbiosis has been associated with carcinogenesis such as colorectal cancer (CRC), hepatocellular carcinoma (HCC), lung cancer, breast cancer, and gastric cancer. The dysbiotic pathogenesis may be species-based or community-based and can have varying mechanisms of carcinogenesis. The human virome was also associated with certain cancers. Viruses, such as cytomegalovirus (CMV), Human herpesvirus 8 (HHV-8), human papilloma virus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Epstein-Barr virus (EBV), all had associations with cancers. It was also reported that an altered bacteriophage community may lead to carcinogenesis by allowing opportunistic, oncogenic bacteria to proliferate in a gastrointestinal biofilm. This mechanism shows the importance of analyzing the bacteriome and the virome concurrently as their interactions can provide insight into new mechanisms in the pathogenesis of not only cancer, but other diseases as well. The enteric bacteriome was shown to be distinctly altered in immunocompromised HIV-infected individuals, and highly active antiretroviral therapy (HAART) was shown to at least partially reverse the alterations that HIV causes in the bacteriome. Studies have shown that the progression to HIV is associated with changes in the plasma concentration of commensal viruses. HIV also acts synergistically with multiple other viruses, such as HPV, EBV, varicella zoster virus (VZV), and HHV-8. Although it has been shown that HIV infection leads to enteric virome expansion in humans, most of the research on HIV's effect on the virome was conducted in non-human primates, and there is a lack of research on the effect of HAART on the virome. Virome-wide analysis is necessary for identifying novel viral etiologies. There is currently a wealth of information on the bacteriome and its associations with cancer and HIV, but more research should be conducted on the virome's associations and reaction to HAART as well as the bacteriome-virome interactions that may play a major role in pathogenesis and recovery.
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Affiliation(s)
- Jonathan Stern
- Department of Basic Science, New York University College of Dentistry, New York, NY 10010, United States
| | - George Miller
- S. Arthur Localio Laboratory, Departments of Surgery, New York University, School of Medicine, New York, NY 10016, United States
| | - Xin Li
- Department of Basic Science, New York University College of Dentistry, New York, NY 10010, United States
| | - Deepak Saxena
- Department of Basic Science, New York University College of Dentistry, New York, NY 10010, United States; S. Arthur Localio Laboratory, Departments of Surgery, New York University, School of Medicine, New York, NY 10016, United States.
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17
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Ferreira MVM, Cavalcanti ÉFF, PM Rubini ND, Ferreira DC, Gonçalves LS, V Colombo AP. Oral status and periodontal microbiota of HIV-infected youth infected by vertical transmission. Future Virol 2018. [DOI: 10.2217/fvl-2018-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This study evaluated the oral status and microbiota of HIV+ youth infected by vertical transmission. Materials & methods: 34 HIV+ and 36 HIV- individuals (14–24 years of age) were examined for oral infections/lesions. Subgingival biofilm was collected and the microbiota determined by checkerboard DNA–DNA hybridization. Results: Over 90% of the HIV+ youth were under highly active antiretroviral therapy, but 64.6% had AIDS and 47% presented oral manifestations. HIV+ youth showed more periodontal attachment loss and inflammation than HIV- (p < 0.05), and also high prevalence of caries. Most species were detected in higher prevalence in the microbiota of HIV+ than controls. Conclusion: HIV+ youth infected by vertical transmission presented more periodontal destruction and inflammation, and greater prevalence of microbial pathogens compared with HIV- individuals.
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Affiliation(s)
- Mariana VM Ferreira
- School of Dentistry, Department of Clinics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Medical Microbiology, Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Édila FF Cavalcanti
- School of Dentistry, Department of Clinics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Norma de PM Rubini
- Department of Allergy & Immunology, Gafrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Dennis C Ferreira
- School of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Lucio S Gonçalves
- School of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Ana Paula V Colombo
- Department of Medical Microbiology, Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Charone S, Portela MB, Martins KDO, Soares RM, Castro GF. Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study. J Appl Oral Sci 2017; 25:53-60. [PMID: 28198976 PMCID: PMC5289400 DOI: 10.1590/1678-77572016-0021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 09/23/2016] [Indexed: 02/07/2023] Open
Abstract
Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.
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Affiliation(s)
- Senda Charone
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Rio de Janeiro, RJ, Brasil.,Universidade de Brasília, Faculdade de Odontologia, Departamento de Cariologia, Brasília, DF, Brasil
| | - Maristela Barbosa Portela
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Clínica e Odontopediatria, Niterói, RJ, Brasil
| | - Karol de Oliveira Martins
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Clínica e Odontopediatria, Niterói, RJ, Brasil
| | - Rosangela Maria Soares
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia, Rio de Janeiro, RJ, Brasil
| | - Gloria Fernanda Castro
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Rio de Janeiro, RJ, Brasil
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Rajonson N, Meless D, Ba B, Faye M, Diby JS, N'zore S, Datté S, Diecket L, N'Diaye C, Aka EA, Kouakou K, Ba A, Ekouévi DK, Dabis F, Shiboski C, Arrivé E. High prevalence of dental caries among HIV-infected children in West Africa compared to uninfected siblings. J Public Health Dent 2017; 77:234-243. [PMID: 28233316 DOI: 10.1111/jphd.12203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 12/02/2016] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The objectives of this study were to investigate the association between HIV infection and dental caries among children in West Africa, and to identify factors associated with dental caries among HIV-infected children. METHODS We conducted a multi-center cross-sectional study in Mali, Senegal and Côte d'Ivoire with a random sample of HIV-infected children aged 5-15 years on antiretroviral therapy and their uninfected siblings. A standardized examination was performed by calibrated dentists. The association between the number of decayed, missing or filled permanent and primary teeth surfaces (DMFdefS) and HIV status was investigated by fitting multivariable zero-inflated negative binomial models, for each age group (<12 and ≥12 years). Factors associated with dental caries could be investigated only for HIV-infected children <12 years old. RESULTS The sample included 420 HIV-infected children and 418 non-infected siblings. The median DMFdefS was 7 for the HIV-infected children and 2 for the uninfected siblings. The proportion of children with DMFdefS ≥1 was significantly higher among the HIV-infected children than uninfected children (86.0 percent versus 64.4 percent, P < 0.001). The HIV-infected children were less likely to be caries-free than the uninfected siblings in both age groups. We found a higher degree of caries experience among HIV-infected children < 12 years old, in whom it was associated with sweet drink consumption, history of night bottle use, immunosuppression, and younger age at study entry. CONCLUSIONS Although preventable, the burden of dental disease was high in children from families affected by HIV in West Africa and was associated with HIV infection and immunosuppression.
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Affiliation(s)
- Noëlla Rajonson
- Université de Bordeaux, UFR, d'Odontologie, Bordeaux, France.,INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France
| | - David Meless
- Universite Felix Houphouet-Boigny, UFR d'Odontostomatologie, Abidjan, Côte d'Ivoire.,Programme PAC-CI/CHU de Treichville, Abidjan, Côte d'Ivoire
| | | | - Malick Faye
- Hopital d'Enfants Albert Royer, Dakar, Senegal
| | | | - Serge N'zore
- Université de Cocody, CCTOS, Cocody, Abidjan, Côte d'Ivoire
| | | | | | | | | | | | - Abou Ba
- Hopital d'Enfants Albert Royer, Dakar, Senegal
| | | | - François Dabis
- INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France.,Université Bordeaux, ISPED, Centre INSERM U1219- Epidémiologie-Biostatistique, Bordeaux, France
| | - Caroline Shiboski
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Elise Arrivé
- Université de Bordeaux, UFR, d'Odontologie, Bordeaux, France.,INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France
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