Gingival Recession and Localized Aggressive Periodontitis Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy
Gingival Recession and Localized Aggressive Periodontitis Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy
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DOI：
10.1097/inf.0000000000002166
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发表时间：
2019-06-01
影响因子：
3.6
通讯作者：
Feucht, Ute D.
中科院分区：
文献类型：
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作者：
Blignaut, Elaine;Rossouw, Theresa M.;Feucht, Ute D.
背景：关于艾滋病毒感染儿童和青少年牙龈萎缩或局部侵袭性牙周炎的信息有限。本研究报告了接受抗逆转录病毒治疗（ART）的儿童和青少年中这些疾病的患病率。研究方法：一项关于2013年1月至2016年6月期间在南非豪登的儿科艾滋病诊所就诊的艾滋病感染儿童和青少年的横断面研究。患者接受口腔检查和口腔卫生指导，无论口腔或牙齿相关的投诉。管理和记录硬组织和软组织病理学以及相关人口统计学和临床数据。在Stata 14中进行统计分析，P < 0.05为显著性。结果如下：共纳入554名5-19岁的儿童和青少年（中位年龄：12.2岁;四分位数间距：10.3-14.9），其中78名（14.1%）出现下颌恒切牙牙龈退缩和/或磨牙局部侵袭性牙周炎。多变量logistic回归分析显示，牙龈退缩和侵袭性牙周炎患者的ART持续时间明显较短，并且更有可能在一线和二线治疗病毒学失败后获得次优的HIV控制（CD 4计数= 50拷贝/mL）和高级ART方案。结论：研究结果强调了艾滋病毒感染儿童和青少年从一开始就进行口腔保健的重要性，以预防和管理可能导致牙齿脱落和永久性毁容的疾病。这在病毒学失败和免疫抑制的情况下特别重要。
Background: Limited information is available on gingival recession or localized aggressive periodontitis among HIV-infected children and adolescents. This study reports on the prevalence of these conditions among children and adolescents receiving antiretroviral therapy (ART). Methods: A cross-sectional study on HIV-infected children and adolescents attending a Pediatric HIV clinic in Gauteng, South Africa, between January 2013 and June 2016. Patients received an oral examination and oral hygiene instructions, irrespective of oral- or dental-related complaints. Hard and soft tissue pathology was managed and recorded, together with relevant demographic and clinical data. Statistical analysis was performed in Stata 14 with P < 0.05 as significant. Results: A total of 554 children and adolescents 5-19 years of age (median age: 12.2 years; interquartile range: 10.3-14.9) were included, of whom 78 (14.1%) presented with gingival recession on permanent mandibular incisors and/or localized aggressive periodontitis of molar teeth. Multivariable logistic regression revealed that patients with gingival recession and aggressive periodontitis had a significantly shorter duration of ART and were more likely to have suboptimal HIV control (CD4 count = 50 copies/mL) and be on advanced ART regimens after virologic failure on first- and second-line treatment. Conclusions: The results emphasize the importance of oral health care among HIV-infected children and adolescents from the onset, to prevent and manage conditions that could result in tooth loss and permanent disfigurement. This is of particular importance in the presence of virologic failure and immunosuppression.