Dental caries in association with viral load in children living with HIV in Phnom Penh, Cambodia: a cross-sectional study

Abstract

Background: Oral health status is known to be associated with overall health among people living with HIV. However, it is unclear whether dental caries is associated with viral load among this population. In particular, dental caries among children living with HIV needs to be better understood, 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 was conducted at the National Paediatric Hospital as a baseline survey of a randomized controlled trial. The study population included children living with HIV aged 3–15 years and their primary caregivers. We collected data on the children’s oral health status by oral examination and the latest HIV viral load data stored in the patients’ information system at the hospital. We also conducted a questionnaire-based interview of the children and their primary caregivers. 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 number of permanent or deciduous teeth with caries was 7.7 (standard deviation, 5.0). In the regression analysis, dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio: 1.07, 95% confidence interval: 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 also positively associated with non-suppression of viral load (>1000 copies/mL) (adjusted odds ratio: 1.12, 95% confidence interval: 1.03–1.23).Conclusions: Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that oral health status may affect the immune status of children. 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.

Prevalence of dental caries and associated risk factors among HIV-positive and HIV-negative adults at an HIV clinic in Kigali, Rwanda

“…The results of our study also revealed a significant association between detectable HIV RNA-viral load and caries among HIV+ respondents after adjusting for the other factors not related to HIV-infection. Similar to the results of our study, different researchers have also found an association between HIV RNA-viral load with dental caries [6,23,35,36]. These findings may suggest that dental caries can affect the immunity of HIV+ individuals.…”

“…Since the introduction of highly active antiretroviral treatment (HAART) in 1996, the life expectance of HIV-positive (HIV+) people has considerably increased [6,7]. HAART has also significantly reduced the occurrence of HIV-related oral lesions [8].…”