Oral manifestations of HIV infection in children.

Human immunodeficiency virus (HIV) infection was first recognized in children in 1983 and has now assumed the proportions of a major public health challenge. This article briefly reviews, on the basis of the literature, the epidemiology, diagnosis, clinical and immunologic characteristics, and prognosis of HIV infection in children. The clinical oral manifestations in children are described on the basis of the literature and the personal observations of HIV-infected pediatric patients.     

Oral manifestations of HIV infection in 36 Nigerian children

Oral manifestations of HIV/AIDS are early and common clinical indicators of HIV infection. There has been no report on the clinical prevalence of oral lesions associated with HIV infection in children in sub-Saharan Africa. We report the findings of a cross sectional study of 36 Nigerian children seen at the Pediatrics Infectious Disease Clinic of the AIDS Prevention Initiative in Nigeria (APIN), Jos University Teaching Hospital (JUTH) Jos, Nigeria.     

Oral manifestations of HIV

The infection of the root canal system is considered to be a polymicrobial infection, consisting of both aerobic and anaerobic bacteria. Because of the complexity of the root canal infection, it is unlikely that any single antibiotic could result in effective sterilization of the canal. A combination of antibiotic drugs (metronidazole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are possible sources of endodontic lesions. Three case reports describe the nonsurgical endodontic treatment of teeth with large periradicular lesions. A triple antibiotic paste was used for 3 months. After 3 months, teeth were asymptomatic and were obturated. The follow-up radiograph of all the three cases showed progressive healing of periradicular lesions. The results of these cases show that when most commonly used medicaments fail in eliminating the symptoms then a triple antibiotic paste can be used clinically in the treatment of teeth with large periradicular lesions.     

Oral manifestations of HIV infected children undergoing highly active antiretroviral therapy

Oral manifestations in paediatric HIV infection are diverse and show differences in clinical presentation and severity from that of adults. Very little data exist for oral lesions in paediatric population in India. We aimed to evaluate the oral manifestations of Paediatric HIV seropositive patients undergoing highly active antiretroviral therapy (HAART). The cross sectional study was conducted on forty four HIV positive children in the age group of 8–14 years undergoing HAART at NGO centres in Salem district were included in the study. Children were examined for oral lesions and diagnosed in accordance with European council Clearinghouse-World Health Organization. Patients were classified with respect to their immune status based on CD4 count. The common oral manifestations associated with HIV were found to be reduced with the introduction of HAART.     

Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda

The aim of this study was to assess the orofacial manifestations and their influence on oral function in human immunodeficiency virus (HIV) positive children attending Mildmay Clinic in Uganda. This was a cross-sectional study based on clinical examination, medical records and a structured questionnaire of 368 children aged between 1.5 and 17 years. The clinical examination for dental caries was based on decayed, extracted and filled teeth (deft) and decayed, missing and filled teeth (DMFT) indices as defined by World Health Organisation. The soft tissue orofacial lesions were assessed using the classification and diagnostic criteria as described by the Collaborative Workgroup on the Oral Manifestations of Pediatric HIV Infections. Approximately 67.4% of the children were on highly active antiretroviral therapy (HAART). The majority (77.4%) of the children had at least one orofacial lesion associated with HIV, pseudomembranous candidiasis being the most prevalent. Overall, 61.7% of the children with orofacial lesions reported at least one form of discomfort in the mouth. Discomfort was particularly associated with swallowing. The prevalence of orofacial lesions was significantly higher in children with poor oral hygiene and lower in those on HAART than in their respective counterparts. The CD4+ cell count, age and gender of the children did not significantly influence the distribution of orofacial lesions. The mean deft and DMFT scores were 11.8 and 2.7, respectively. The d- and D-components contributed 54.7 and 42.1%, respectively. Consumption of sugary snacks was directly associated with dental caries. Despite these children attending an HIV care centre of excellence, they have a high prevalence of orofacial manifestations associated with HIV. The majority of the children experienced discomfort in the oral cavity, particularly during swallowing.     

Oral manifestations in untreated HIV patient

AIDS-related lesions have decreased significantly since the advent of highly active anti-retroviral therapy (HAART). We describe an untreated, homeless 44-year-old male with a six-year history of HIV who presented himself with Kaposi sarcoma, candidiasis, scrofula and a generalized severe periodontitis. This report highlights the importance of identifying and diagnosing AIDS-related oral lesions seen in an untreated HIV-positive patient.     

Oral manifestations of aplastic anemia in children

BACKGROUND: Few studies concerning oral manifestations of aplastic anemia (AA) in children have been reported. The purpose of the authors' study was to describe oral lesions in children with AA. METHODS: The authors conducted a retrospective review using medical records of children diagnosed with AA who were treated at the Pediatric Service of the Regional Hospital of Concepción, Chile, between March 1996 and May 2001. They recorded episodes of oral mucosal lesions and assessed platelet and neutrophil counts at the time the oral lesions appeared. RESULTS: Twelve children (nine boys and three girls) were diagnosed with AA. Their age range was 3 to 12 years (median age, 7 years). Nine subjects were receiving immunosuppressive therapy, and three received only supportive care. The most common oral manifestation of the disease was hemorrhage, which developed most often in patients with platelet counts less than 25 x 10(9) cells/liter. The second and third most common oral manifestations were candidiasis and viral infection, respectively. CONCLUSIONS: Children with AA frequently exhibit oral manifestations of the condition. Prevention, early diagnosis and proper treatment of oral complications are essential to diminish morbidity and avoid a possible fatal outcome. CLINICAL IMPLICATIONS: Oral lesions can be the first manifestation of AA; consequently, dentists should be aware of these manifestations so that an early diagnosis of the disease can be made.     

Oral manifestations of HIV infection in 75 Dutch patients

Seventy-five consecutive HIV-infected patients, including 33 AIDS cases were examined. One or more oral mucosal lesions were observed in 57 (76%); candidiasis was the most common finding (52%). Others included hairy leukoplakia (16%), periodontal disease (16%) and Kaposi's sarcoma (4%). Diversity of study design and methods allowed no reliable comparison with other reports.     

Oral manifestations and dental status in paediatric HIV infection

Objective . To describe the incidence and prevalence of oral manifestations of HIV infection in a population of perinatally infected children.
Design . Retrospective and prospective study of a cohort of perinatally HIV-infected children.
Setting. Community hospital and community-based paediatric clinic.
Sample and methods . Forty perinatally HIV-infected children with a median age of 12 months were eligible and selected for the study, which included a medical chart review from birth and prospective follow-up. Each child was examined quarterly for oral manifestations, tooth eruption, and for 27 children, caries and periodontal status.
Results . The incidence of pseudomembranous candidiasis was 43% (95% CI, 27–58%) within 6 months of birth. Oral candidiasis (defined as pseudomembranous or erythematous) was positively associated with low CD4 counts and the occurrence of plaque. Children with low CD4 counts were also found to have fewer teeth than children with high CD4 counts, after adjusting for age.
Conclusions . Oral manifestations are common in paediatric HIV infection and are possible predictors of HIV disease progression. Primary care of HIV-infected children should include periodic oral examinations to monitor their HIV disease progression and to alleviate symptoms associated with oral opportunistic infections.     

72例HIV/AIDS口腔病损的临床观察

目的：分析HIV感染者和AIDS患者常见口腔病损,以期提高临床医师对AIDS早期临床表现的认识,提高早期诊断准确性。方法：回顾分析72例HIV／AIDS患者临床症状、体征和实验室检查,分析口腔病损在AIDS早期诊断中的意义及与病程进展的关系。结果：常见口腔病变有：口腔白色念珠菌病、疱疹性口炎、非特异性口腔溃疡,其它病损如颌面部淋巴结炎、毛状白斑、卡波济肉瘤、带状疱疹、涎腺肿大,牙周病等,可单发或同时伴发。全身系统性疾病主要包括：肺炎、慢性腹泻、结核等。结论：AIDS患者发病前已开始出现明显口腔表现,其中以口腔白色念珠菌感染最为常见,对非法采供血、输血、静脉吸毒或不安全性行为等特殊人群,如出现难以治愈的”霉菌性口炎”或反复发作、原因不明的疱疹性口炎,或出现毛状白斑、卡波济肉瘤等口腔病变,应及时进行HIV检测。     

Oral manifestations of acute leukemia in children.

Seventy-seven children with acute leukemia were examined. A wide spectrum of oral findings was observed as the consequence of direct leukemic infiltration of tissue, infection resulting from bone marrow and immunosuppression, impaired healing responses, and poor oral hygiene. Guidelines for dental treatment are provided.