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Risk factors for HIV-related orofacial soft-tissue manifestations in children
F J Ramos-Gomez1, J F Hilton, A J Canchola
1Department of Growth and Development, University of California-San Francisco, USA.
Insights
Orofacial lesions are common in children with human immunodeficiency virus (HIV) infection. These oral manifestations can indicate disease progression and predict the development of acquired immunodeficiency syndrome (AIDS).
Area of Science:
- Pediatric Infectious Diseases
- Oral Medicine
- Immunology
Background:
- Perinatal exposure to human immunodeficiency virus (HIV) can lead to various health complications in children.
- Orofacial manifestations are recognized clinical signs in HIV-infected individuals.
Purpose of the Study:
- To compare orofacial soft-tissue manifestations in HIV-infected versus non-infected children.
- To identify risk factors for oral lesions in HIV-infected children.
- To determine if specific oral lesions predict HIV disease progression.
Main Methods:
- Retrospective review of medical records for 492 children with perinatal HIV exposure.
- Comparison of 91 HIV-positive children with 185 HIV-seronegative controls.
- Analysis of orofacial lesions including oropharyngeal candidiasis, parotid enlargement, and herpes simplex.
Main Results:
- Oropharyngeal candidiasis (OPC) was significantly more prevalent in HIV-infected children (67%) than controls (8%).
- Parotid enlargement and herpes simplex also showed higher prevalence in the HIV-infected group.
- OPC correlated significantly with HIV disease progression markers like failure to thrive, lower CD4 counts, and AIDS development.
Conclusions:
- Orofacial manifestations are common in pediatric HIV infection.
- Specific oral lesions, particularly OPC, serve as indicators of HIV infection.
- These lesions can predict disease progression towards acquired immunodeficiency syndrome (AIDS).
Abstract:
A retrospective review of the medical records of 492 children perinatally exposed to the human immunodeficiency virus (HIV) compared the prevalence of orofacial soft-tissue manifestations in HIV-infected and noninfected children, identified risk factors for occurrence of orofacial lesions in HIV-infected children, and investigated specific orofacial lesions as indicators of progression of HIV disease. Application of eligibility criteria and the Centers for Disease Control classification of pediatric HIV infection resulted in selection of a study group of 91 HIV-positive children and a control group of 185 HIV-seronegative children who had seroreverted. Analysis of oral lesions showed that 67% of the study group and 8% of the control group had oropharyngeal candidiasis (OPC), 4% of the study group and 0% of the control group had parotid enlargement, and 3% of the study group and 0% of the control group had herpes simplex; all three differences were significant at P < 0.04. No statistically significant association was found between OPC and the risk factors of gender, ethnicity, or mode of delivery (vaginal versus cesarean). However, OPC was associated significantly with all progression markers examined: failure to thrive, use of antiretroviral agents, lower CD4 counts, and development of acquired immunodeficiency syndrome (AIDS). Orofacial manifestations are common in pediatric HIV infection and may serve as markers of infection and predictors of progression of HIV disease to AIDS.