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Onyia NE, Osagie E, Akhigbe P, Idemudia NL, Obuekwe O, Omoigberale A, Richards V, Coker MO. Impact of perinatal HIV exposure and infection on salivary properties among Nigerian children. BMC Oral Health 2024; 24:460. [PMID: 38627731 PMCID: PMC11020910 DOI: 10.1186/s12903-024-04159-z] [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: 01/31/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND There is growing evidence that perinatal HIV infection and exposure affect salivary pH and flow rate in children in most parts of the world, but not against the background of caries and the African demographic. This study aimed to evaluate the impact of HIV infection as well as exposure on salivary properties and their influence upon the dental caries experience among school-aged children in Nigeria. METHOD This cross-sectional study assessed the salivary flow rates and salivary pH of HIV infected and exposed school-aged (4-11) children receiving care at a Nigerian tertiary hospital. A total of 266 consenting participants which comprised of three groups as follows: (1) HIV Infected (HI) (n = 87), (2) HIV Exposed and Uninfected (HEU) (n = 82) and (3) HIV Unexposed and Uninfected (HUU) (n = 97) were recruited for the study. Questionnaires completed by parents/guardians were used for data collection. Three calibrated dentists performed oral examinations for dental caries. International Caries Detection and Assessment Scores (ICDAS) was used and presented as dmft/DMFT. Salivary pH was measured using MColourpHast™ pH indicator strips, while salivary flow rate was determined by collecting unstimulated whole saliva using the suction method. Data analysis relied on comparative statistics to determine the correlation between HIV exposure and infection on salivary pH and flow rates. RESULT Across the groups, (HI, HEU, and HUU) mean pH of the HI was significantly less than that of HEU and HUU. Similarly, there was a statistically significant difference in the SFR across the three groups (p = 0.004). Other variables such as gender, age and oral hygiene status expressed by the gingival inflammatory scores had no significant influence on the pH and SFR of study participants. There was a rather unexpected positive correlation of DMFT of HI and HEU groups with increasing salivary flow rate; though, the relationship was weak and not significant. CONCLUSION Perinatal HIV exposure and infection significantly impact salivary pH and flow rate among school-aged children in Nigeria. The findings of this study imply that HIV infection influenced the salivary pH, while HIV maternal exposure (without infection) impacted salivary flow rates when compared to the controls.
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Affiliation(s)
- Nonso E Onyia
- Department of Oral Pathology Oral Medicine Oral Diagnosis, University of Calabar, Calabar, Cross River State, Nigeria
| | - Esosa Osagie
- Research Department, Institute of Human Virology, Abuja, Nigeria
| | - Paul Akhigbe
- Research Department, Institute of Human Virology, Abuja, Nigeria
| | - Nosakhare L Idemudia
- Medical Microbiology Division, Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Ozo Obuekwe
- Department of Oral and Maxillofacial Surgery, University of Benin, Benin City, Nigeria
| | | | - Vincent Richards
- Department of Biological Sciences, Clemson University, Clemson, SC, USA
| | - Modupe O Coker
- Department of Oral Biology, Rutgers University, Newark, NJ, USA.
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Radithia D, Subarnbhesaj A, Ayuningtyas NF, Bakti RK, Mahdani FY, Pratiwi AS, Ayunnisa N, Putri SF, Pramitha SR. Oral hyperpigmentation as an adverse effect of highly active antiretroviral therapy in HIV patients: A systematic review and pooled prevalence. J Clin Exp Dent 2023; 15:e561-e570. [PMID: 37519321 PMCID: PMC10382165 DOI: 10.4317/jced.60195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 05/22/2023] [Indexed: 08/01/2023] Open
Abstract
Background Human Immunodeficiency Virus (HIV) infects patients via CD4+ cells which are later be destroyed subsequently causing the deteriotation of immune system. HIV generally manifests in the oral cavity as the first indicating sign and a marker of disease progression. HAART medications are used to reduce the incidence of oral manifestations, however it can also generate adverse effects in the oral cavity including oral hyperpigmentation. This review aimed to estimate the prevalence of oral hyperpigmentation which affect individual quality of life as a side effect of HAART. Material and Methods This systematic review applied Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020. Literature search was performed in ScienceDirect, PubMed, and Scopus by combining terms such as highly active antiretroviral therapy, oral manifestation, epidemiology or prevalence published between January 1998 to March 2022. Results Of 108 articles, eleven articles were included for systematic review and meta-analysis. The pooled prevalence of oral hyperpigmentation in HAART patients was 25% (95% CI: 11%, 38%; I2: 99%). Subgroup analysis based on geographical location showed varied result may be due to the type and duration of HAART used in study population. The most widely used type of ARV was from the NRTI group (n=7) and the study with the shortest duration showed the lowest oral hyperpigmentation prevalence (n=7). Conclusions There is an increased prevalence of oral hyperpigmentation by the use of HAART. Future study should investigate the correlation between HAART duration and the degree of oral hyperpigmentation. Key words:HAART, oral hyperpigmentation; pooled prevalence.
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Affiliation(s)
- Desiana Radithia
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Ajiravudh Subarnbhesaj
- Department of Oral Biomedical Science, Division of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, 40002, Thailand
| | | | - Reiska-Kumala Bakti
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Fatma-Yasmin Mahdani
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Aulya-Setyo Pratiwi
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Naqiya Ayunnisa
- Bachelor Dental Science Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Salsabila-Fitriana Putri
- Bachelor Dental Science Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Selviana-Rizky Pramitha
- Oral Medicine Specialist Study Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
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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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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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Shekatkar M, Kheur S, Gupta AA, Arora A, Raj AT, Patil S, Khan SS, Desai A, Carroll WB, Awan KH. Oral candidiasis in human immunodeficiency virus-infected patients under highly active antiretroviral therapy. Dis Mon 2021; 67:101169. [PMID: 33640178 DOI: 10.1016/j.disamonth.2021.101169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human immunodeficiency virus has plagued mankind since the 1980's when the first case was documented. Human immunodeficiency virus-induced immunocompromised state can lead to several systemic and local manifestations, which often culminates in mortality. Oral candidiasis was one of the most prevalent opportunistic infections noted in human immunodeficiency virus-infected patients. The advent of highly active antiretroviral therapy has led to a significant reduction in both the mortality and the morbidity of infected patients. The combined antiretroviral therapy has also led to a decrease in the incidence of opportunistic infections including oral candidiasis. Thus, the presence of well-established oral candidiasis in human immunodeficiency virus-infected patients under highly active antiretroviral therapy could be considered as an indicator of potential treatment failure. The present manuscript aims to review the published literature assessing the effect of highly active antiretroviral therapy on the incidence of oral candidiasis in human immunodeficiency virus-infected patients.
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Affiliation(s)
- Madhura Shekatkar
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Supriya Kheur
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Archana A Gupta
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Aavishi Arora
- Dr. D. Y. Patil Dental College, and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India
| | - A Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Samar Saeed Khan
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ami Desai
- Department of Oral Pathology and Microbiology, People's College of Dental Sciences and Research Centre, People's University; Bhopal, India
| | - William B Carroll
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
| | - Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA.
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Rafat Z, Sasani E, Salimi Y, Hajimohammadi S, Shenagari M, Roostaei D. 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. Front Pediatr 2021; 9:805527. [PMID: 35004551 PMCID: PMC8740125 DOI: 10.3389/fped.2021.805527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/07/2021] [Indexed: 11/19/2022] Open
Abstract
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 I 2, 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 I 2 (I 2 = 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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Affiliation(s)
- Zahra Rafat
- Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Sasani
- Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Yahya Salimi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samaneh Hajimohammadi
- Department of Toxicology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Shenagari
- Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.,Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Davoud Roostaei
- Department of Pharmacology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Shu W, Li C, Du F, Bai J, Duan K. A real-world, cross sectional study of oral lesions and their association with CD4 cell counts and HIV viral load in Yunnan, China. Medicine (Baltimore) 2020; 99:e22416. [PMID: 33019418 PMCID: PMC7535679 DOI: 10.1097/md.0000000000022416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Human immunodeficiency virus (HIV) supresses immune system, primarily cell-mediated immunity. Cluster of differentiation 4 (CD4) cell count, viral load, and oral lesions are the most important laboratory parameters to evaluate the evolution of acquired immunodeficiency syndrome. The present study aims to determine the incidence of HIV-related oral lesions with CD4 cell count and viral load in Yunnan, China.A cross-sectional study was conducted from December 2007 to December 2009, in 1812 HIV positive patients from Department of Infectious Diseases in Kunming Third People's Hospital. CD4, CD8, and viral load data were collected and analyzed statistically using SPSS 11.3.Out of 1812 HIV positive patients, 929 (51.27%) were associated with 1 or more oral lesions. The most common oral lesions observed were Candida Pseudomembranous (13.75%), Candida erythematous (10.93%), Oral hairy leukoplakia (7.95%), Aphthous ulcer (6.18%), Herpes simplex infection (5.58%). In most patients with oral lesions, the CD4 cell count was < 200/μL. The incidence of oral lesions was lower when CD4 count was > 200/μL and with undetectable (P < .01) HIV viral load. Almost no oral lesions was observed when CD4 count > 500/μL (P < .01). With highly active antiretroviral therapy, reduction in HIV-related oral lesions was observed especially in Candida erythematous, Candida Pseudomembranous, Oral hairy leukoplakia, and Aphthous ulcer.The higher incidence of oral lesions with lower CD4 count (<200/μL) in HIV-infected patients indicated importance of CD4 cell count in identifying disease progression.
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Affiliation(s)
- Wen Shu
- Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City
| | - Chengwen Li
- Department of Research Management, The third affiliated hospital of Kunming Medical University
| | - Fei Du
- Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City
| | - Jinsong Bai
- Department of Infectious Diseases, Kunming Third People's Hospital, Kunming, China
| | - Kaiwen Duan
- Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City
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Oral Manifestations in HIV-Positive Children: A Systematic Review. Pathogens 2020; 9:pathogens9020088. [PMID: 32023908 PMCID: PMC7168689 DOI: 10.3390/pathogens9020088] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 12/20/2022] Open
Abstract
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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Mary EO, Abiola OA, Titilola G, Mojirayo OO, Sulaimon AA. Prevalence of HIV related oral lesions in people living with HIV and on combined antiretroviral therapy: a Nigerian experience. Pan Afr Med J 2018; 31:180. [PMID: 31086631 PMCID: PMC6488253 DOI: 10.11604/pamj.2018.31.180.13574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 06/22/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction oral lesions comprise significant clinical features of HIV infection and are often indicators of immune suppression. However, the advent of antiretroviral therapy has significantly reduced its prevalence. The aim of this study was to relate the prevalence of oral lesions of HIV to treatment outcome of Combined Antiretroviral Therapy (cART) in a Nigerian HIV adult population. Methods a cross- sectional study was conducted on 491 People Living with HIV (PLWHIV) on cART from two HIV centres in Lagos state, Nigeria. The EC-clearing house guidelines were employed to categorise oral lesions. Presence or absence of these lesions was reconciled with CD4+ cell count as a measure of efficacy of cART treatment. Results a total of 491 PLWHIV on cART were enrolled, 366 (74.5%) were females and 125 (25.5%) were males. Age ranged between 18-80 years, with a mean of 41.2 ± 9.1 years. On examination, 12 (2.4%) patients presented with HIV oral lesions. Oral hyperpigmentation (10, 2.0%) was the most common lesion seen, followed by oral ulcers (2,0.4%). Majority (75%) of the affected patients were on a Lamivudine containing regimen. 7 out of the 12 patients with oral lesions had CD4+ cell count between 200-500 cell/mm3 prior to cART initiation. Eleven (92%) of the patients with oral lesions had significant improvement of their CD4+ cell count after cART administration. Conclusion the prevalence of oral lesions in HIV patients on cART therapy in Lagos is low. Oral hyperpigmentation and oral ulcers are the most frequent lesions seen. The presence or absence of oral lesions were not associated with CD4+ cell count. Therefore, we conclude that the oral lesions seen in HIV patients on cART may not be a direct manifestation of the disease.
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Affiliation(s)
- Eweka Olutola Mary
- Oral Medicine Unit, Department of Preventive Dentistry, College of Medicine University of Lagos, Lagos, Nigeria
| | - Ogbenna Ann Abiola
- Department of Haematology and Blood Transfusion, College of Medicine University of Lagos, Lagos, Nigeria
| | | | - Ogundana Oladunni Mojirayo
- Department of Oral and Maxillofacial Pathology/Biology, College of Medicine University of Lagos, Lagos, Nigeria
| | - Akanmu Alani Sulaimon
- Department of Haematology and Blood Transfusion, College of Medicine University of Lagos, Lagos, Nigeria
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Araújo JFD, Oliveira AEFD, Carvalho HLCCD, Roma FRVDO, Lopes FF. Most common oral manifestations in pediatric patients HIV positive and the effect of highly active antiretroviral therapy. CIENCIA & SAUDE COLETIVA 2018; 23:115-122. [PMID: 29267817 DOI: 10.1590/1413-81232018231.19072015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 12/18/2015] [Indexed: 11/21/2022] Open
Abstract
This integrative literature review aims to identify the main oral lesions affecting pediatric patients with HIV, and describe the effect of highly active antiretroviral therapy (HAART) on these injuries, comparing it to antiretroviral therapy (ART). A search was conducted in PubMed and Scielo databases, following predetermined inclusion and exclusion criteria. 19 papers were selected and the main information on the prevalence and frequency of oral manifestations in HIV-positive pediatric patients and effect of therapy applied were extracted. The most frequent injuries were oral candidiasis, gingivitis, parotid gland enlargement and linear gingival erythema. The use of HAART shown to reduce the prevalence of oral manifestations in pediatric patients with HIV and be more effective than ART. The findings of this study suggest that the most frequent oral manifestation in HIV-infected children is oral candidiasis, followed by changes such as gingivitis and enlargement parotid glands. The use of HAART appears to reduce the prevalence of these oral lesions, showing more effective results than ART.
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Affiliation(s)
- Joyce Figueira de Araújo
- Departamento de Odontologia II, Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. Portugueses s/n, Bacangá. 65000-000 São Luís MA Brasil.
| | - Ana Emília Figueiredo de Oliveira
- Departamento de Odontologia II, Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. Portugueses s/n, Bacangá. 65000-000 São Luís MA Brasil.
| | | | - Fábia Regina Vieira de Oliveira Roma
- Departamento de Odontologia II, Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. Portugueses s/n, Bacangá. 65000-000 São Luís MA Brasil.
| | - Fernanda Ferreira Lopes
- Departamento de Odontologia II, Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. Portugueses s/n, Bacangá. 65000-000 São Luís MA Brasil.
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Mandal PK, Mitra M, Acharya S, Ghosh C, Mohanty S, Saha S. Salivary IgA versus HIV and Dental Caries. J Clin Diagn Res 2016; 10:ZC61-ZC64. [PMID: 27790582 DOI: 10.7860/jcdr/2016/19394.8531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/11/2016] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The inter-relationship of Human Immunodeficiency Virus (HIV) infection and dental caries as well as Salivary Immunoglobulin-A (S-IgA) level appear to remain under explored while a manual and electronic search of the literature was made. Hence, the present study was undertaken to assess the relationship of S-IgA and dental caries status in HIV positive children. AIM The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV positive and negative children and determine the dental caries status in HIV positive and HIV negative children, which may help in treatment planning and prevention of the same. MATERIALS AND METHODS A total of 28 HIV positive children aged between 6-14 years and 28 age matched HIV negative children were included in this study and both samples were randomly selected from the same Non-Governmental Organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. Only 2cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to WHO criteria (1997) using a flat mouth mirror and CPI probe. RESULTS In HIV +ve group mean S-IgA level was calculated as 81.61 ± 6.20 μg/ml, mean DMFT was 3.86 ± 3.37, mean deft was 4.75 ± 2.86. In HIV -ve group mean S-IgA level was calculated as 145.57 ± 17.83μg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong-ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, p < 0.001) and negative but Not Significant (N.S.) correlation (r = -0.19, t = 0.99, p > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, p < 0.001), S-IgA and deft (r = -0.942, t =14.32, p=<0.001) was found in HIV-ve group. CONCLUSION This study suggests that the individuals who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.
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Affiliation(s)
- Pradip Kumar Mandal
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, SOA University , Bhubaneswar, Odisha, India
| | - Malay Mitra
- Professor and Head of Department, Department of Pedodontics and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital , Kolkata, West Bengal, India
| | - Sonu Acharya
- Professor, Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, SOA University , Bhubaneswar, Odisha, India
| | - Chiranjit Ghosh
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Haldia Institute of Dental science and Research , Haldia, West Bengal, India
| | - Susant Mohanty
- Professor and Head of Department, Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences, SOA University , Bhubaneswar, Odisha, India
| | - Subrata Saha
- Professor, Department of Pedodontics and Preventive Dentistry Dr. R. Ahmed Dental College and Hospital , Kolkata, West Bengal, India
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12
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Satyakiran GVV, Bavle RM, Alexander G, Rao S, Venugopal R, Hosthor SS. A relationship between CD4 count and oral manifestations of human immunodeficiency virus-infected patients on highly active antiretroviral therapy in urban population. J Oral Maxillofac Pathol 2016; 20:419-426. [PMID: 27721607 PMCID: PMC5051290 DOI: 10.4103/0973-029x.190934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: Human immunodeficiency virus (HIV) infection gradually destroys the body's immune system, which makes it harder for the body to fight infections. HIV infection causes a quantitative and qualitative depletion of CD4 lymphocyte count, which increases the risk of opportunistic infections. Thus, CD4 count is one of the key factors in determining both the urgency of highly active antiretroviral therapy (HAART) initiation and the need of prophylaxis for opportunistic infections. Aim: This study aims to evaluate the prevalence and variations in the oral manifestations of HIV/acquired immune deficiency syndrome patients on HAART therapy in urban population and their association with CD4 count. Materials and Methods: A study was conducted by screening eighty patients who were HIV positive in an urban location. Both adult and pediatric patients were screened for oral manifestations and simultaneously CD4 count was also evaluated. Patients with HIV infection for variable time period who are under HAART were considered. Statistical Analysis: Measures of central tendency were used to analyse the data. Results: HIV infection destroys the immune system of an individual, making the patient susceptible to various infections and malignancies. With the advent of antiretroviral therapy, the scenario has changed drastically. We have observed that patients with CD4 counts between 164 and 1286 show relatively few oral manifestations. Long-term HAART therapy causes pigmentation, xerostomia and angular cheilitis but is taken up quite well by the patients. Conclusion: In this study, eighty patients with HAART from urban population showed very minimal oral findings because of good accessibility for treatment and awareness about HIV infections. The patients who were on long-standing HAART treatment also showed minimal oral manifestation such as pigmentation and xerostomia. Hence, we conclude that recognition, significance and treatment of these lesions in patients with HIV infection do not require elaborate setup and can be treated with basic primary health care.
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Affiliation(s)
| | - Radhika Manoj Bavle
- Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Glory Alexander
- Managing Director, Asha Foundation, Indiranagar, Bangalore, Karnataka, India
| | - Saritha Rao
- Consultant Peadiatrician, Asha Foundation, Indiranagar, Bangalore, Karnataka, India
| | - Reshma Venugopal
- Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Sreelatha S Hosthor
- Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
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13
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Arrive E, Meless D, Anaya-Saavedra G, Gallottini M, Pinzon LM, Ramirez-Amador V. The global burden of oral diseases in pediatric HIV-infected populations: a workshop report. Oral Dis 2016; 22 Suppl 1:149-57. [PMID: 26882532 DOI: 10.1111/odi.12417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/22/2015] [Accepted: 11/02/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To achieve a comprehensive understanding about the global burden of oral diseases in HIV-infected children and to identify research needs. MATERIALS AND METHODS A literature search was conducted in PubMed (2009-2014) to address five questions: (i) prevalence of oral diseases in HIV-infected compared with uninfected children, (ii) impact of oral diseases on quality of life, (iii) effect of antiretroviral exposure in utero on craniofacial and dental development, (iv) important co-infections and antiretroviral complications, and (v) value of atraumatic restorative treatment. RESULTS Studies showed a high prevalence of dental caries in HIV-infected children but the relationship between HIV infection and dental caries remains unclear. Also quality of life needs further investigation supported by better study designs and improvement of the instruments used. Up-to-date evidence suggested long-term harms associated with in utero antiretroviral exposure were minor but would require long-term follow-up through National Registries. The reviews also revealed the wide spectrum of metabolic disease due to antiretroviral therapy and co-infections such as tuberculosis. Finally, atraumatic restorative technique appears to be a simple and safe technique to treat dental caries but outcomes need further evaluation. CONCLUSIONS The impact of antiretroviral therapy in HIV-infected children has raised novel challenging questions in the field of oral health warranting future research.
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Affiliation(s)
- E Arrive
- UFR d'Odontologie, University of Bordeaux, Bordeaux, France.,Equipe VIH et Santé Globale, INSERM U897, Bordeaux, France
| | - D Meless
- UFR d'Odontostomatologie, Félix Houphouët Boigny University of Abidjan, Abidjan, Côte d'Ivoire
| | - G Anaya-Saavedra
- Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - M Gallottini
- Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - L M Pinzon
- School of Dentistry, University of California, San Francisco, CA, USA.,School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - V Ramirez-Amador
- Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
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14
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Gaitán-Cepeda LA, Sánchez-Vargas O, Castillo N. Prevalence of oral candidiasis in HIV/AIDS children in highly active antiretroviral therapy era. A literature analysis. Int J STD AIDS 2015; 26:625-32. [PMID: 25156369 DOI: 10.1177/0956462414548906] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/03/2014] [Indexed: 02/05/2023]
Abstract
SummaryHighly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy.
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Affiliation(s)
- Luis Alberto Gaitán-Cepeda
- Laboratory of Oral Pathology, Postgraduate and Research Division, Dental School, National Autonomous University of Mexico, Coyoacan, México
| | - Octavio Sánchez-Vargas
- Laboratory of Microbiology, Pathology and Biochemical, Faculty of Stomatology, Autonomous University of San Luis Potosi, San Luis Potosí, México
| | - Nydia Castillo
- Microbiology area, Health Sciences Center, Autonomous University of Baja California, Valle de las Palmas, Tijuana, Baja California, México
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15
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Oliveira CAGR, Tannure PN, de Souza IPR, Maia LC, Portela MB, Castro GFBDA. Is dental caries experience increased in HIV-infected children and adolescents? A meta-analysis. Acta Odontol Scand 2015; 73:481-7. [PMID: 25765439 DOI: 10.3109/00016357.2014.958874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To undertake a systematic review to assess if HIV-infected children and adolescents have an increased dental caries experience. METHODS A search of MEDLINE, BIREME, EMBASE, GOOGLE SCHOLAR, SIGLE (Grey Literature) and reference lists of included studies was carried out. To be eligible the studies had to present HIV-infected and non-infected children/adolescents between 0-18 years old. To assess the methodological quality, the studies were categorized in scores from 'A' to 'C'. To perform a meta-analysis a random effect model was used with 95% confidence intervals and two distinct sub-group analyses were carried out in terms of caries progression: data for cavitated and non-cavitated lesions (sub-group 1) and data only for cavitated lesions (sub-group 2). RESULTS Five studies fulfilled the selection criteria. Four studies (two ranked A and two B in the quality assessment) revealed higher caries scores in primary teeth in the HIV-infected patients with mean dmft/dmfs scores of 3.8-4.1/7.8-11.0 compared to the control group 1.5-2.4/3.4-5.1. No differences in caries index were found for permanent dentition. The meta-analysis excluded caries data of permanent teeth and showed a significant association between caries experience in primary dentition and HIV infection considering cavitated and non-cavitated lesions (OR = 2.33, 95% CI = 1.48-3.68) or only cavitated lesions (OR = 2.98, 95% CI = 1.59-5.59). CONCLUSION Evidence exists that suggests HIV-infected children/adolescents have an increased caries experience in primary dentition.
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16
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Rovaris NS, Galato D, Schuelter-Trevisol F, da Silva J, Linhar LDS, Nickel DA, Traebert J. Oral health status and its impact on the quality of life of children and adolescents living with HIV-1. BMC Res Notes 2014; 7:478. [PMID: 25069518 PMCID: PMC4118649 DOI: 10.1186/1756-0500-7-478] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 07/21/2014] [Indexed: 11/12/2022] Open
Abstract
Background Oral health problems can generate considerable negative effects on the quality of life of individuals living with HIV. The aim of this study was investigate the oral health status and its impact on the quality of life of 1 to 18 years-old living with HIV-1 under follow-up at referral centers in Southern Brazil. Methods A cross-sectional study involving individuals under follow-up (n = 36) was carried out. The individuals living with HIV-1 and their guardians underwent individual interviews using validated questionnaires for assessing oral health-related quality of life according to age group. Clinical oral examinations were performed to establish oral health status, in terms of caries and treatment need, HIV-1-related gingival as well as stomatological changes. Medical records were reviewed searching for clinical history of the infection and the presence of HIV-1-related diseases. Association studies between frequent/very frequent oral health-related impact on quality of life and independent variables were performed using Fisher’s exact test. Results The prevalence of frequent/very frequent oral health-related impact on quality of life was 69.0%. The prevalence of caries was 75.9%. Gingival changes were present in 20.7% of the individuals. Dental treatment was needed in 72.4% of the patients. HIV-1-related disease was present in 55.2%. The variables significantly associated with the prevalence of frequent/very frequent impact on oral health-related quality of life were dental treatment need (p = 0.037) and being more than 12 years of age (p = 0.041). Conclusions Individuals living with HIV-1 with need for dental treatment and those over 12-years of age reported a statistically higher frequency of frequent/very frequent oral health-related impact on quality of life.
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Affiliation(s)
| | | | | | | | | | | | - Jefferson Traebert
- Graduate Program in Health Sciences, University of Southern Santa Catarina, 88704-900 Tubarão, SC, Brazil.
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Rezaei-Soufi L, Davoodi P, Abdolsamadi HR, Jazaeri M, Malekzadeh H. Dental caries prevalence in human immunodeficiency virus infected patients receiving highly active anti-retroviral therapy in kermanshah, iran. CELL JOURNAL 2014; 16:73-8. [PMID: 24518976 PMCID: PMC3933441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 02/24/2013] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Introduction of new approaches for the treatment of human immunodeficiency virus (HIV) infection such as anti-retroviral medicines has resulted in an increase in the life expectancy of HIV patient. Evaluating the dental health status as a part of their general health care is needed in order to improve the quality of life in these patients. The aim of this study was to compare the root and crown caries rate in HIV patients receiving highly active antiretroviral therapy (HAART) with that rate in HIV patients without treatment option. MATERIALS AND METHODS This cross sectional study consisting of 100 individuals of both genders with human immunodeficiency virus were divided into two groups: i. group 1 (treatment group) including 50 patients with acquired immunodeficiency syndrome (AIDS) receiving HAART and ii. group 2 (control group) including 50 HIV infected patients not receiving HAART. Dental examinations were done by a dentist under suitable light using periodontal probe. For each participant, numbers of decay (D), missed (M), filled (F), Decayed missed and filled teeth (DMFT), decay surface (Ds), missed surface (Ms), filled surface (Fs), Decayed missed and filled surfaces (DMFS), and tooth and root caries were recorded. Data were analyzed using Chi-square test and independent t test using SPSS 13.0, while p-value of <0.05 was considered statistically significant in all analysis. RESULTS The mean and standard deviation (SD) of decayed, missed and filled teeth of those who were on highly active antiretroviral therapy was 6.86 ± 3.57, 6.39 ± 6.06 and 1.89 ± 1.93, respectively. There was no significant difference between these values regarding to the treatment of patients. The mean and standard deviation of DMFT, DMFS and the number of decayed root surfaces were 15.14 ± 6.09, 56.79 ± 28.56, and 4.96 ± 2.89 in patients treated by anti-retroviral medicine which were not significantly different compared to those without this treatment. CONCLUSION According to the results of the present study, highly active antiretroviral therapy could not be considered as a single factor for dental caries prevalence in HIV-infected patients. However, more research is recommended to evaluate the cariogenic potential of these medicines.
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Affiliation(s)
- Loghman Rezaei-Soufi
- Department of Operative Dentistry, Dental Research Center, Faculty of Dentistry, Hamadan University of Medical
Sciences, Hamadan, Iran
| | - Poorandokht Davoodi
- Department of Oral Medicine, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Reza Abdolsamadi
- Department of Oral Medicine, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mina Jazaeri
- Department of Oral Medicine, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Malekzadeh
- Department of Oral Medicine, Faculty of Dentistry, Jundishapour University of Medical Sciences, Ahvaz, Iran
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