Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Research and Education Center for Prevention of Global Infectious Diseases of Animals, Tokyo University of Agriculture and Technology, Tokyo, Japan.
BMC Oral Health. 2021 Mar 25;21(1):159. doi: 10.1186/s12903-021-01441-2.
Oral health status is associated with the overall health among people living with human immunodeficiency virus (HIV) infection. However, it is unclear whether dental caries is associated with the viral load in this population. Particularly, dental caries among children living with HIV needs better understanding 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.
This cross-sectional study, conducted at the National Pediatric Hospital as a baseline survey of a randomized controlled trial, included 328, 3-15-year-old children living with HIV and their primary caregivers. Calibrated and trained examiners conducted oral examinations for dental caries (DMFT/dmft index) in the children and retrieved the latest HIV viral load data from the hospital's patient information system. On the dental examination day, the children and their caregivers were invited to answer a questionnaire-based interview. 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.
Data from 328 children were included in the analysis; 68.3% had an undetectable viral load. The mean DMFT/dmft was 7.7 (standard deviation = 5.0). Adjusted regression analysis showed that dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 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 positively associated with non-suppression of viral load (> 1000 copies/mL) (AOR: 1.12, CI: 1.03-1.23).
Dental caries was associated with viral load status detection among children living with HIV. This finding suggests that dental caries may affect their immune status. 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.
口腔健康状况与感染人类免疫缺陷病毒（HIV）人群的整体健康状况相关。然而，HIV 感染者的龋齿是否与病毒载量相关尚不清楚。特别是，HIV 感染儿童的龋齿情况需要更好地了解，因为这可能会影响他们的整体健康和未来福祉。本研究评估了柬埔寨金边感染 HIV 的儿童的龋齿与病毒载量之间的关联。
本横断面研究在国家儿科医院进行，是一项随机对照试验的基线调查，共纳入 328 名 3-15 岁感染 HIV 的儿童及其主要照顾者。经过校准和培训的检查者对儿童进行口腔检查以评估龋齿（DMFT/dmft 指数），并从医院的患者信息系统中检索最新的 HIV 病毒载量数据。在口腔检查日，邀请儿童及其照顾者回答基于问卷的访谈。采用多因素逻辑回归分析评估龋齿与病毒载量之间的关联。将无法检测到的病毒载量的截止值设定为 <40 拷贝/mL。
纳入 328 名儿童的数据进行分析；68.3%的儿童病毒载量不可检测。DMFT/dmft 的平均值为 7.7（标准差=5.0）。调整后的回归分析显示，恒牙和乳牙的龋齿与可检测的病毒载量呈正相关（调整后的优势比 [AOR]：1.07，95%置信区间 [CI]：1.01-1.14）。相反，抗逆转录病毒治疗≥1 年和自我报告的抗逆转录病毒药物更高的依从性与可检测的病毒载量呈负相关。在具有可检测病毒载量的儿童中，恒牙和乳牙的龋齿与病毒载量未得到抑制（>1000 拷贝/mL）呈正相关（AOR：1.12，CI：1.03-1.23）。
HIV 感染儿童的龋齿与病毒载量检测结果相关。这一发现表明，龋齿可能会影响他们的免疫状态。应加强 HIV 感染儿童的口腔健康，需要进一步研究以阐明病毒载量与口腔健康状况之间的因果关系。
