Caregivers’ report of HIV‐associated oral manifestations among HIV‐unexposed, exposed, and infected Kenyan children

BACKGROUND Few oral health studies have been conducted in HIV-exposed uninfected children, who, like their HIV-infected peers, have altered immunity and perinatal drug exposures. AIM To compare caregiver' self-report of oral diseases, hygiene practices and utilization of routine dental care, between HIV-infected (HIV), exposed uninfected (HEU), and unexposed uninfected (HUU) children in Kenya. DESIGN This nested cross-sectional study was conducted at the Kenyatta National Hospital. Caregivers of 196 children (104 HIV-infected, 55 HEU and 37 HUU), participated in this study. Using a validated questionnaire from the WHO and photos of HIV-related oral lesions, we collected data on oral diseases and oral health practices. RESULTS Caregivers of HIV-infected children reported at least one oral disease in their children (42%) (HEU (27%); HUU (17%) (p=0.008)). Oral candidiasis was the most common disease reported (HIV-infected (24%), HEU (5.5%), HUU (2.8%; p<0.05)). Baseline CD4% was associated with oral candidiasis (OR=0.93, 95% CI: 0.88-0.98). Only 16% of children had ever visited a dentist, and most initiated brushing after 3 years of age (83%). Nearly all (98%) caregivers desired a follow-up oral exam. CONCLUSIONS HIV-infection/exposure, and low CD4% were associated with increased odds of oral diseases. Most caregivers desired a follow-up oral examination for their children.