title: Oral lesions among HIV-infected children on antiretroviral treatment in West Africa.
abstract: OBJECTIVE
  To estimate the prevalence of oral mucosal diseases and dental caries among HIV-infected children receiving antiretroviral treatment (ART) in West Africa and to identify the factors associated with the prevalence of oral mucosal lesions.
  
  
  METHODS
  Multicentre cross-sectional survey in five paediatric HIV clinics in Côte d'Ivoire, Mali and Sénégal. A standardised examination was performed by trained dentists on a random sample of HIV-infected children aged 5-15 years receiving ART. The prevalence of oral and dental lesions and mean number of decayed, missing/extracted and filled teeth (DMFdefT) in temporary and permanent dentition were estimated with their 95% confidence interval (95% CI). We used logistic regression to explore the association between children's characteristics and the prevalence of oral mucosal lesions, expressed as prevalence odds ratio (POR).
  
  
  RESULTS
  The median age of the 420 children (47% females) enrolled was 10.4 years [interquartile range (IQR) = 8.3-12.6]. The median duration on ART was 4.6 years (IQR = 2.6-6.2); 84 (20.0%) had CD4 count<350 cells/mm(3). A total of 35 children (8.3%; 95% CI: 6.1-11.1) exhibited 42 oral mucosal lesions (24 were candidiasis); 86.0% (95% CI = 82.6-89.3) of children had DMFdefT ≥ 1. The presence of oral mucosal lesions was independently associated with CD4 count < 350 cells/mm(3) (POR = 2.96, 95% CI = 1.06-4.36) and poor oral hygiene (POR = 2.69, 95% CI = 1.07-6.76).
  
  
  CONCLUSIONS
  Oral mucosal lesions still occur in HIV-infected African children despite ART, but rarely. However, dental caries were common and severe in this population, reflecting the need to include oral health in the comprehensive care of HIV.
authors.affiliation: Programme PAC-CI/CHU de Treichville, Abidjan, Côte d'Ivoire.|Département de Santé Publique, UFR Odontostomatologie, Université FHB, Abidjan, Côte d'Ivoire.
authors.forename: David
authors.initials: D
authors.lastname: Meless
authors.affiliation: CHU d'Odonto-Stomatologie, Bamako, Mali.
authors.forename: Boubacar
authors.initials: B
authors.lastname: Ba
authors.affiliation: Hopital d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Malick
authors.initials: M
authors.lastname: Faye
authors.affiliation: PMI Yopougon-Attié, Abidjan, Côte d'Ivoire.
authors.forename: Jean-Serge
authors.initials: JS
authors.lastname: Diby
authors.affiliation: CCTOS, Abidjan, Côte d'Ivoire.
authors.forename: Serge
authors.initials: S
authors.lastname: N'zoré
authors.affiliation: CCTOS, Abidjan, Côte d'Ivoire.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Datté
authors.affiliation: CHU de Yopougon, Abidjan, Côte d'Ivoire.
authors.forename: Lucrèce
authors.initials: L
authors.lastname: Diecket
authors.affiliation: Hôpital Gabriel Touré, Bamako, Mali.
authors.forename: Clémentine
authors.initials: C
authors.lastname: N'Diaye
authors.affiliation: CePReF Enfant, Abidjan, Côte d'Ivoire.
authors.forename: Edmond Addi
authors.initials: EA
authors.lastname: Aka
authors.affiliation: CIRBA, Abidjan, Côte d'Ivoire.
authors.forename: Kouadio
authors.initials: K
authors.lastname: Kouakou
authors.affiliation: Hopital d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Abou
authors.initials: A
authors.lastname: Ba
authors.affiliation: Programme PAC-CI/CHU de Treichville, Abidjan, Côte d'Ivoire.|Inserm U897, Equipe VIH et Santé Globale, Bordeaux, France.
authors.forename: Didier Koumavi
authors.initials: DK
authors.lastname: Ekouévi
authors.affiliation: Inserm U897, Equipe VIH et Santé Globale, Bordeaux, France.|Université Bordeaux Segalen, Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Shiboski
authors.affiliation: Inserm U897, Equipe VIH et Santé Globale, Bordeaux, France.|Université Bordeaux Segalen, Bordeaux, France.
authors.forename: Elise
authors.initials: E
authors.lastname: Arrivé
mesh_terms: D000293:Adolescent; D000354:Africa, Western / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D016017:Odds Ratio; D009909:Oral Health / Q000706:statistics & numerical data; D009910:Oral Hygiene / Q000706:statistics & numerical data; D010306:Parotid Gland / Q000473:pathology
chemical_list: D044966:Anti-Retroviral Agents
keywords: Africa; Côte d'Ivoire; HIV; Mali; Sénégal; antiretroviral therapy; child; oral health