Prevalence of oral colonization and infection by Candida and of untreated caries in pediatric patient with aids / Prevalência de colonização e infecção bucal por Candida e de cárie não-tratada em pacientes pediátricos com aids

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

This study assessed the prevalence of oral colonization and infection caused by Candida, as well of untreated caries in pediatric patients with aids attended at the Clinic for Infection Diseases, Child Institute, Clinic Hospital of the University of São Paulo, Brazil. The prevalence of colonization and infection by Candida was evaluated among hundred seventeen, 3 to 15-years-old (mean age of 9.4 years) children, and the requirement for dental treatment among 125 children of the same age group. General clinical condition, medications in use and laboratories findings were obtained from the medical chart of each patient. Dental examination followed WHO guidelines for oral health surveys; data on demographic conditions were extracted from questionnaires filled in by familial caregivers. Prevalence of untreated caries were evaluated in relation to socioeconomic, behavioral and clinical conditions. Poisson regression analysis adjusted by age assessed covariates for the prevalence of untreated dental caries and Candida colonization. Results indicated 62% of prevalence of oral colonization by Candida (54%-72%, confidence interval 95%). Clinical manifestation of oral candidosis was low (7%) despite of low CD4, and both high viral load and Candida colonization detected among most children. Positive result for Candida colonization associates with frequent use of antibiotics (prevalence ratio PR = 1.44), sulfa drugs (PR = 1.23), alteration on the oral mucosa (PR = 1.55), and untreated dental caries (PR = 1.93); negative association occurred with the use of antiretroviral therapies (PR = 0.65). Candida albicans was the most frequent species (80%); non-albicans species 18%. Phenotipic testes did not allowed to detect any colonization by C. dubliniensis. Prevalence of untreated dental caries either on one deciduous or one permanent tooth affected 58% of the patients, a rate higher than that registered among the same group age, non-HIV-children in the state of São Paulo, Brazil. Being attended by high school graduated caregivers represented a reduction factor of prevalence of caries (PR = 0.51), while household crowding (PR = 1.53) and daily sugar intake (PR = 1.44) was associated with a higher prevalence of caries. Viral load higher than 100,000 copies/ml (PR = 1.41) and severe symptom of aids manifestations (PR = 1.39) also associated with poorer dental status. The present study revealed low prevalence of oral lesions, an indicative that antiretroviral therapies results satisfactory for aids treatment and HIV+/aids-children, and that aids-affected children have higher prevalence of untreated caries than in non-affected children in the same group age. The high prevalence of both Candida colonization and untreated caries in HIV+/aids-children reinforces the importance of a health-care professional to the interdisciplinary team that assists those patients.

ASSUNTO(S)

aids aids candida hiv infection infecção hiv dental caries socio-demographic condition condições sóciodemográficas candida cárie dentária

ACESSO AO ARTIGO

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