The association between oral disease and type of antiretroviral therapy among perinatally HIV-Infected youth

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Abstract

Objectives:

This study explores the association between combination antiretroviral therapy (cART) and oral health outcomes (dental and periodontal) among perinatally HIV-infected (PHIV) youth.

Methods:

We conducted a cross-sectional study of oral health among PHIV youth participating in the Oral Health substudy of Pediatric HIV/AIDS Cohort Study (PHACS). Dentists at research sites were trained/calibrated on how to perform a standardized oral mucosal, dental, and periodontal examination. They assessed the decayed-missing-filled-surfaces and teeth index (DMFS/T). The number of decayed surfaces and teeth (DS/DT), and the number of teeth with bleeding on probing for each participant were derived from the examination. Data for analysis included lifetime measurements of CD4 count and viral load (VL), socio-demographic information, and current/ past history of ART.

Results:

Among 209 PHIV youth, 95% were on ART at the time of enrollment. Among 143 PHIV youth on the same cART for at least one year, we found that the mean DT score of those receiving cART containing an integrase inhibitor (II) was 86% higher than that of those on cART without an II after adjusting for age, lifetime proportion of unsuppressed VL and CD4 nadir. Initiating protease inhibitors (PI) before age 6 years was associated with a significantly lower DMFT score compared to participants who initiated at age 6 and older.

Conclusion:

Our study revealed that PHIV youth who received cART containing II had a significantly higher number of untreated active caries than those on cART without II. This may warrant closer dental surveillance of those receiving II.

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