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Gingival Recession and Localized Aggressive Periodontitis Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy

Blignaut, Elaine, PhD*; Rossouw, Theresa M., PhD; Becker, Piet J., PhD; Mavuso, Diana S., BDS*; Feucht, Ute D., PhD§

The Pediatric Infectious Disease Journal: June 2019 - Volume 38 - Issue 6 - p e112–e115
doi: 10.1097/INF.0000000000002166
HIV Reports

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 ≤500 cells/µL and/or HIV viral load ≥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.

From the *Department of Oral Pathology and Oral Biology, School of Dentistry

Department of Immunology, School of Medicine

Research Support Office

§Department of Paediatrics, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.

Accepted for publication June 14, 2018.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Elaine Blignaut (BChD, MSc, PhD), Department of Oral Pathology and Oral Biology, School of Dentistry, P.O. Box 1266, Oral and Dental Hospital, University of Pretoria, Pretoria 0001, South Africa. E-mail

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