The Burden of Oral Disease among Perinatally HIV-Infected and HIV-Exposed Uninfected Youth.
OBJECTIVE
To compare oral health parameters in perinatally HIV-infected (PHIV) and perinatally HIV-exposed but uninfected youth (PHEU).


METHODS
In a cross-sectional substudy within the Pediatric HIV/AIDS Cohort Study, participants were examined for number of decayed teeth (DT), Decayed, Missing, and Filled Teeth (DMFT), oral mucosal disease, and periodontal disease (PD). Covariates for oral health parameters were examined using zero-inflated negative binomial regression and ordinal logistic regression models.


RESULTS
Eleven sites enrolled 209 PHIV and 126 PHEU. Higher DT scores were observed in participants who were PHIV [Adjusted Mean Ratio (aMR) = 1.7 (95% CI 1.2-2.5)], female [aMR = 1.4 (1.0-1.9)], had no source of regular dental care [aMR = 2.3 (1.5-3.4)], and had a high frequency of meals/snacks [≥5 /day vs 0-3, aMR = 1.9 (1.1-3.1)] and juice/soda [≥5 /day vs 0-3, aMR = 1.6 (1.1-2.4)]. Higher DMFT scores were observed in participants who were older [≥19, aMR = 1.9 (1.2-2.9)], had biological parent as caregiver [aMR = 1.2 (1.0-1.3)], had a high frequency of juice/soda [≥5 /day vs 0-3, aMR = 1.4 (1.1-1.7)] and a low saliva flow rate [mL/min, aMR = 0.8 per unit higher (0.6-1.0)]. Eighty percent had PD; no differences were seen by HIV status using the patient-based classifications of health, gingivitis or mild, moderate, or severe periodontitis. No associations were observed of CD4 count and viral load with oral health outcomes after adjustment.


CONCLUSIONS
Oral health was poor in PHIV and PHEU youth. This was dismaying since most HIV infected children in the U.S. are carefully followed at medical health care clinics. This data underscore the need for regular dental care. As PHIV youth were at higher risk for cavities, it will be important to better understand this relationship in order to develop targeted interventions.
Department of Pediatrics, Division of Adolescent Medicine, University of California, Los Angeles, Los Angeles, California, United States of America.
Anna-Barbara
http://orcid.org/0000-0002-6317-5233
AB
Moscicki
Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Tzy-Jyun
TJ
Yao
Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, California, United States of America.
Mark I
MI
Ryder
Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Jonathan S
JS
Russell
Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America.
Stephen S
SS
Dominy
Department of Epidemiology, Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Kunjal
K
Patel
Center for Biostatistics in AIDS Research (CBAR), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Matt
M
McKenna
Department of Pediatrics, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
Russell B
RB
Van Dyke
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
George R
GR
Seage
Maternal and Pediatric Infectious Disease Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, United States of America.
Rohan
R
Hazra
D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D002648:Child; D003430:Cross-Sectional Studies; D003945:Diagnosis, Oral; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D006801:Humans; D008297:Male; D010510:Periodontal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D014076:Tooth Diseases / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D019562:Viral Load; D055815:Young Adult