Abstract
BackgroundOral 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.MethodsThis 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.ResultsData 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).ConclusionsDental 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.
Highlights
Oral health status is associated with the overall health among people living with human immunodeficiency virus (HIV) infection
This study aimed to assess the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia
Study design This cross-sectional study was conducted from February to April 2018 as a baseline survey of a randomized controlled trial (Clinical Trial Number: ISRCTN15177479) aiming to improve the oral health of children living with HIV at the National Pediatric Hospital, Phnom Penh, Cambodia
Summary
Oral health status is associated with the overall health among people living with human immunodeficiency virus (HIV) infection. It is unclear whether dental caries is associated with the viral load in this population. Acquired immunodeficiency syndrome (AIDS)related deaths decreased by 35%, from 1.7 million in 2004 (the highest rate) to 1.1 million in 2018 [1] This change implies that people living with human immunodeficiency. Children living with HIV are no exception to poor oral health, and the condition is even worse than in uninfected children. These children have a higher number of dental caries than children without HIV infection [6]
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