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Folayan MO, Zuñiga RAA, Virtanen JI, Aly NM, Ezechi OC, Lusher J, El Tantawi M, Nguyen AL. Risk indicators for oral ulcers among people living with HIV during the first wave of the pandemic: a cross sectional study. BMC Oral Health 2023; 23:600. [PMID: 37635219 PMCID: PMC10463981 DOI: 10.1186/s12903-023-03330-2] [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: 01/03/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Little is currently known about HIV-related parameters that may increase the risk for oral ulcers during the COVID-19 pandemic. This study aimed to overcome this gap in research by assessing the associations between HIV viral load, antiretroviral adherence profile, co-morbidity status, SARS-CoV-2 infection and oral ulcers among people living with HIV (PLHIV). METHODS This was a secondary analysis of data generated from 21,206 to 18 years and above, recruited from 152 countries through an online survey between July and December 2020. Data were extracted for 874 people who reported living with HIV. The dependent variable was reporting having oral ulcer. The independent variables were the viral load, adherence to antiretroviral treatment and a history of SARS-CoV-2 infection. The confounding variables were age at last birthday and sex at birth. A multivariable logistic regression analysis was conducted to determine the associations between the dependent and independent variables after adjusting for the confounding variables. RESULTS Of the 874 participants, 99 (11.3%) reported having oral ulcers during the first wave of the COVID-19 pandemic. The odds of PLHIV having oral ulcers during the first wave of the COVID-19 pandemic was significantly higher for people who did not know their viral load than those who had undetectable viral load (AOR: 2.036; 95% CI: 1.204-3.443; p = 0.008); and people who did not adhere to the use of antiretroviral treatment than those who adhered (AOR: 4.113; 95% CI: 2.567-6.589; p < 0.001). Also, PLHIV who had SARS-CoV-2 infection had significantly higher odds of having oral ulcers than those who did not have the infection (AOR: 14.556; 95% CI: 4.500-47.078; p < 0.001). PLHIV who had co-morbidities had non-significantly higher odds of having oral ulcers than those without co-morbidities (AOR: 1.170; 95% CI: 0.656-2.085; p = 0.595). CONCLUSION Oral ulcers may be an indicator of poor adherence to antiretroviral therapy and unsuppressed viral load among PLHIV. It may also be an indicator of SARS-CoV-2 infection and a signal to take prompt and critical care of affected individuals because of the risk for severe COVID-19 for these individuals.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria.
| | - Roberto Ariel Abeldaño Zuñiga
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Postgraduate Department, University of Sierra Sur., Oaxaca, Mexico
| | - Jorma I Virtanen
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Nourhan M Aly
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Oliver C Ezechi
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Joanne Lusher
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Provost's Group, Regent's University London, London, UK
| | - Maha El Tantawi
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Annie L Nguyen
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Abstract
Inflammatory bowel disease (IBD) mainly comprises of two separate inflammatory conditions: Crohn's disease (CD) and ulcerative colitis (UC). The aetiology of these conditions is still being explored with current evidence pointing towards a combination of environmental and genetic components. However, the pathophysiology is understood as a cytokine driven inflammatory response. There is significant association between IBD and dental conditions such as dental caries, other infections and periodontitis. Anti-inflammatory medications such as 5 aminosalicylic acid (5ASA), steroids and biological therapies are the treatment of choice for these chronic conditions, dependent on aetiology. Therefore, this article aims to educate dentists regarding possible implications IBD and its treatment can have for clinical practice and future research.
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