Early cART initiation improves dental outcomes in kids

Children who are perinatally infected with HIV have better dental and periodontal outcomes, including less tooth decay and bleeding, when they begin combination ART and integrase or protease inhibitors before the age of 2 years.

Caroline Siboski, DDS, MPH, PhD, professor in the department of orofacial sciences at the University of California, San Francisco, and colleagues wrote that combination ART (cART) effectively maintains immune function and controls the transmission of opportunistic infections, such as oral mucosal diseases, in those infected in HIV.

To determine the dental and periodontal outcomes of children perinatally infected with HIV taking cART, the researchers conducted a cross-sectional study that included participants in the Oral Health substudy of the Pediatrics HIV/AIDS Cohort Study. At enrollment, 89% of the 209 participants aged 10 to 21 years were on cART.

According to the researchers, 143 youths maintained the same cART treatment for a minimum of 1 year. Those who received an integrase inhibitor had 86% higher decayed teeth scores than those not receiving an integrase inhibitor. Participants who began cART at age 6 years or older had a median of 11.5 teeth, with two or more sites with bleeding on probing, a significantly higher number than those who began cART before 2 years of age (median number, five teeth).

Furthermore, when children started protease inhibitors at age 6 years or older, the Siboski and colleagues observed significantly higher scores concerning decayed, missing or filled teeth when compared with those who started treatment before 2 years of age (median, 8.5 vs. 4).

“Our finding suggests that youth receiving integrase inhibitors should undergo close surveillance of their dental status through preventative visits,” Siboski and colleagues wrote. “Earlier initiation of cART and protease inhibitors seems to be associated with less gingival inflammation and lower [number of decayed, missing or filled teeth].” – by Katherine Bortz

Reference:

Siboski C, et al. Abstract 0493. Presented at: The 96th General Session & Exhibition of the International and American Associations for Dental Research Pan European Regional Congress; July 25-28, 2018, London, England.

Disclosures: The authors report no relevant financial disclosures.