Aguirre-Ipenza Rubén, Bautista-Pariona Anthony, Viguria-Chavez Yolanda, Huapaya-Cabrera Alejandro Hector, Coronel-Zubiate Franz Tito, Luján-Valencia Sara Antonieta, Amaya-Riveros Elda, Arbildo-Vega Heber Isac
Faculty of Health Sciences, Universidad Continental, Lima, 15046, Perú.
Faculty of Human Medicine, Universidad Nacional del Santa, Ancash, Perú.
BMC Oral Health. 2025 May 10;25(1):700. doi: 10.1186/s12903-025-06015-0.
To evaluate the evidence regarding the association between antiretroviral therapy and dental caries in children and adolescents with HIV.
Searches were conducted in five international databases (PubMed, Scopus, EMBASE, CENTRAL, and LILACS) from the inception of records up to October 2024, including studies that examine the impact of antiretroviral therapy on caries in individuals under 18 years of age. The risk of bias was assessed using the Newcastle-Ottawa Scale. Quantitative synthesis was performed using the inverse variance method or Mantel-Haenszel method, depending on the type of outcome analyzed. Measures of association included odds ratios and mean differences, employing a random-effects model with a 95% confidence interval.
A total of 585 studies were identified, of which 17 were selected for qualitative review and 15 were included in the meta-analysis. The meta-analysis revealed a significantly higher risk of dental caries in children and adolescents with HIV undergoing antiretroviral therapy compared to those without the virus (odds ratio of 2.11; 95% CI: 1.41-3.17). Subgroup analysis showed a stronger association in case-control studies and for the DMFT index. The certainty of the evidence according to GRADE was rated as very low.
Despite limited certainty, the results suggest that HIV under antiretroviral therapy is associated with a higher risk of dental caries. It is prudent to interpret these results with caution, considering the methodological limitations of the studies. However, given the possible relevance of this association for public health, it is recommended to consider specific dental care protocols for children and adolescents with HIV, as well as the need for preventive strategies integrated into HIV management.
评估有关抗逆转录病毒疗法与感染艾滋病毒的儿童和青少年龋齿之间关联的证据。
在五个国际数据库（PubMed、Scopus、EMBASE、CENTRAL和LILACS）中进行检索，检索时间从记录起始至2024年10月，包括考察抗逆转录病毒疗法对18岁以下个体龋齿影响的研究。使用纽卡斯尔-渥太华量表评估偏倚风险。根据分析的结果类型，采用逆方差法或曼特尔-海恩泽尔法进行定量综合分析。关联度量包括比值比和均值差，采用具有95%置信区间的随机效应模型。
共识别出585项研究，其中17项被选作定性综述，15项纳入荟萃分析。荟萃分析显示，接受抗逆转录病毒疗法的感染艾滋病毒的儿童和青少年患龋齿的风险显著高于未感染病毒的儿童和青少年（比值比为2.11；95%置信区间：1.41 - 3.17）。亚组分析表明，在病例对照研究以及DMFT指数方面关联更强。根据GRADE评估的证据确定性被评为极低。
尽管确定性有限，但结果表明接受抗逆转录病毒疗法的艾滋病毒感染与更高的龋齿风险相关。鉴于研究的方法学局限性，谨慎解读这些结果是明智的。然而，考虑到这种关联对公共卫生可能具有的相关性，建议考虑为感染艾滋病毒的儿童和青少年制定特定的牙科护理方案，以及将预防策略纳入艾滋病毒管理的必要性。
