High prevalence of dental caries among HIV‐infected children in <scp>W</scp>est <scp>A</scp>frica compared to uninfected siblings

Rajonson, Noella; Meless, David; Ba, Boubacar; Faye, Malick; Diby, Jean-Serge; N'zoré, Serge; Datté, Sébastien; Diecket, Lucrèce; N'Diaye, Clémentine; Kouadio, Kouakou; Ba, A.; Ekouévi, Didier K.; Dabis, François; Shiboski, Caroline H.; Arrivé, Élise

doi:10.1111/jphd.12203

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Additionally, they reported that HIV + children had a significantly higher risk of developing caries than non‐infected children (odds ratio [OR] = 2.58; 95% confidence interval [CI]: 1.04‐6.40; P = .04). Rajonson, et al 15 in their West African cohort of 420 HIV‐infected children reported a significant association between DMFT/S (decayed, missing, filled teeth/surfaces) scores in the permanent dentition, deft (decayed, extracted, filled teeth/surfaces) scores in the primary dentition, and CD4 < 350/mm 3 ( P = .007) but no association with WHO clinical stage 4 ( P = .928). It would have been interesting to note the relationship between the ‘d’ or ‘D’ variable of the def/DMF index as this is a more specific measure of the association between CD4/WHO Stage and tooth decay (caries)—however, this analysis was not reported in this study with a large sample size.…”

Section: Discussionmentioning

confidence: 96%

“…There was also a significant positive correlation between lowered salivary secretion levels in HIV‐infected group and higher tooth surface decay but no linear relationship between S mutans levels and either CD4 + counts or viral load. Rajonson et al 15 from West Africa identified food intake frequency > 3 = times a day, liquid formulation medication intake, sweet drink consumption, sweets, chewing gum consumption, oral hygiene, and daily use of toothpaste as significant risk factors for higher caries levels in HIV‐infected children. Other significant risk factors for higher caries prevalence included age and duration of breast feeding 14 .…”

Section: Discussionmentioning

confidence: 99%

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Is there an association between viral load, CD4 count, WHO staging, and dental caries in HIV‐positive children?

Yengopal

Esan

Joosab

2020

Int J Paed Dentistry

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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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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Is there an association between viral load, CD4 count, WHO staging, and dental caries in HIV‐positive children?

Yengopal

Esan

Joosab

2020

Int J Paed Dentistry

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“…Recent studies compared HI children to uninfected children [ 3 , 4 , 13 , 18 , 24 , 25 ] while only one study included a comparison with HIV-exposed-but-uninfected (HEU) children [ 9 ]. Our earlier findings suggested that the immune status of HI (as reflected in CD4 + percentages and counts) had the greatest influence on the differences in salivary community composition between HI and uninfected children [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Age-specific associations with dental caries in HIV-infected, exposed but uninfected and HIV-unexposed uninfected children in Nigeria

et al. 2022

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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.

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“…There is growing evidence of a higher burden, severity, and risk of dental caries with HIV infection [ 1 – 10 ]. However, there is insufficient data explaining the mechanisms underlying this higher risk at the microbial level.…”

Section: Introductionmentioning

confidence: 99%

Dental caries and its association with the oral microbiomes and HIV in young children—Nigeria (DOMHaIN): a cohort study

et al. 2021

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Background This study seeks to understand better the mechanisms underlying the increased risk of caries in HIV-infected school-aged Nigerian children by examining the relationship between the plaque microbiome and perinatal HIV infection and exposure. We also seek to investigate how perinatal HIV infection and exposure impact tooth-specific microbiomes' role on caries disease progression. Methods The participants in this study were children aged 4 to 11 years recruited from the University of Benin Teaching Hospital (UBTH), Nigeria, between May to November 2019. Overall, 568 children were enrolled in three groups: 189 HIV-infected (HI), 189 HIV-exposed but uninfected (HEU) and 190 HIV-unexposed and uninfected (HUU) as controls at visit 1 with a 2.99% and 4.90% attrition rate at visit 2 and visit 3 respectively. Data were obtained with standardized questionnaires. Blood samples were collected for HIV, HBV and HCV screening; CD4, CD8 and full blood count analysis; and plasma samples stored for future investigations; oral samples including saliva, buccal swabs, oropharyngeal swab, tongue swab, dental plaque were collected aseptically from participants at different study visits. Conclusions Results from the study will provide critical information on how HIV exposure, infection, and treatment, influence the oral microbiome and caries susceptibility in children. By determining the effect on community taxonomic structure and gene expression of dental microbiomes, we will elucidate mechanisms that potentially create a predisposition for developing dental caries. As future plans, the relationship between respiratory tract infections, immune and inflammatory markers with dental caries in perinatal HIV infection and exposure will be investigated.

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High prevalence of dental caries among HIV‐infected children in West Africa compared to uninfected siblings

Abstract: 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.

Cited by 15 publications

References 26 publications

Is there an association between viral load, CD4 count, WHO staging, and dental caries in HIV‐positive children?

Is there an association between viral load, CD4 count, WHO staging, and dental caries in HIV‐positive children?

Age-specific associations with dental caries in HIV-infected, exposed but uninfected and HIV-unexposed uninfected children in Nigeria

Dental caries and its association with the oral microbiomes and HIV in young children—Nigeria (DOMHaIN): a cohort study

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