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Published in: BMC Oral Health 1/2018

Open Access 01-12-2018 | Case report

Extensive dental caries in a HIV positive adult patient on ART; case report and literature review

Authors: Dunstan Kalanzi, Harriet Mayanja-Kizza, Damalie Nakanjako, Nelson K. Sewankambo

Published in: BMC Oral Health | Issue 1/2018

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Abstract

Background

The estimated number of people living with human immunodeficiency virus (HIV) (PLHIV) in Uganda is 1.5 million (7.3%). As of June 2016, 60% (898,197) of PLHIV were enrolled and receiving antiretroviral therapy (ART). In scientific literature, the effect of HIV and ART on dental caries remains equivocal. At the Prosthetics Clinic of the Department of Dentistry, Makerere University College of Health Sciences, we have seen a number of PLHIV who require replacement of missing teeth with partial or complete dentures as a result of extensive caries. Here we report a case of an HIV positive female patient with extensive dental caries resulting in complete edentulous jaws, associated with psychological stress and stigmatization.

Case presentation

A 52-year-old patient, HIV positive for fourteen (14) years and receiving antiretroviral therapy (ART) for the last four years wanted to replace her missing teeth for effective feeding and cosmetic reasons. A diagnosis of partially edentulous maxillary and mandibular arches, cervical caries of tooth # 12, 15, 25, 34 and retained roots of tooth # 11, 13, 22 and 35 was made. Following oral health education and mouth preparation, this patient received a set of removable acrylic full upper and lower dentures.

Conclusion

This case may represent the long-term effects of HIV and ART on oral health status especially tooth surfaces in some PLHIV. Further evaluation is required to ascertain if this was an isolated case or it is a common finding among HIV positive adult patients receiving long-term ART in sub-Saharan Africa. Information emerging from these studies would establish the magnitude of dental caries among PLHIV and guide the development of appropriate oral health care guidelines in the management of people living with HIV.
Literature
1.
go back to reference Uganda AIDS Commission: The Uganda HIV and AIDS country progress reports July 2015–June 2016. 2016. Uganda AIDS Commission: The Uganda HIV and AIDS country progress reports July 2015–June 2016. 2016.
3.
go back to reference Ministry of Health Uganda: National Antiretroviral Treatment Guidelines for adults, adolescents, and children. 2009. Ministry of Health Uganda: National Antiretroviral Treatment Guidelines for adults, adolescents, and children. 2009.
4.
go back to reference Ceballos-Salobrena A, Gaitan-Cepeda LA, Ceballos-Garcia L, Lezama-Del Valle D. Oral lesions in HIV/AIDS patients undergoing highly active antiretroviral treatment including protease inhibitors: a new face of oral AIDS? AIDS Patient Care STDs. 2000;14(12):627–35.CrossRefPubMed Ceballos-Salobrena A, Gaitan-Cepeda LA, Ceballos-Garcia L, Lezama-Del Valle D. Oral lesions in HIV/AIDS patients undergoing highly active antiretroviral treatment including protease inhibitors: a new face of oral AIDS? AIDS Patient Care STDs. 2000;14(12):627–35.CrossRefPubMed
5.
go back to reference Patton LL, McKaig R, Strauss R, Rogers D, Eron JJ Jr. Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2000;89(3):299–304.CrossRefPubMed Patton LL, McKaig R, Strauss R, Rogers D, Eron JJ Jr. Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2000;89(3):299–304.CrossRefPubMed
7.
go back to reference Nittayananta W, Talungchit S, Jaruratanasirikul S, Silpapojakul K, Chayakul P, Nilmanat A, Pruphetkaew N. Effects of long-term use of HAART on oral health status of HIV-infected subjects. Journal of oral pathology & medicine. 2010;39(5):397–406. Nittayananta W, Talungchit S, Jaruratanasirikul S, Silpapojakul K, Chayakul P, Nilmanat A, Pruphetkaew N. Effects of long-term use of HAART on oral health status of HIV-infected subjects. Journal of oral pathology & medicine. 2010;39(5):397–406.
8.
go back to reference Navazesh M, Mulligan R, Karim R, Mack WJ, Ram S, Seirawan H, Greenspan J, Greenspan D, Phelan J, Alves M. Effect of HAART on salivary gland function in the Women's interagency HIV study (WIHS). Oral Dis. 2009;15(1):52–60.CrossRefPubMed Navazesh M, Mulligan R, Karim R, Mack WJ, Ram S, Seirawan H, Greenspan J, Greenspan D, Phelan J, Alves M. Effect of HAART on salivary gland function in the Women's interagency HIV study (WIHS). Oral Dis. 2009;15(1):52–60.CrossRefPubMed
9.
go back to reference Nittayananta W, Chanowanna N, Jealae S, Nauntofte B, Stoltze K. Hyposalivation, xerostomia and oral health status of HIV-infected subjects in Thailand before HAART era. Journal of oral pathology & medicine. 2010;39(1):28–34.CrossRef Nittayananta W, Chanowanna N, Jealae S, Nauntofte B, Stoltze K. Hyposalivation, xerostomia and oral health status of HIV-infected subjects in Thailand before HAART era. Journal of oral pathology & medicine. 2010;39(1):28–34.CrossRef
10.
go back to reference Newton JT, Fiske J, Foote O, Frances C, Loh IM, Radford DR. Preliminary study of the impact of loss of part of the face and its prosthetic restoration. J Prosthet Dent. 1999;82(5):585–90.CrossRefPubMed Newton JT, Fiske J, Foote O, Frances C, Loh IM, Radford DR. Preliminary study of the impact of loss of part of the face and its prosthetic restoration. J Prosthet Dent. 1999;82(5):585–90.CrossRefPubMed
11.
12.
go back to reference Davis DM, Fiske J, Scott B, Radford DR. Prosthetics: the emotional effects of tooth loss: a preliminary quantitative study. Br Dent J. 2000;188(9):503–6.PubMed Davis DM, Fiske J, Scott B, Radford DR. Prosthetics: the emotional effects of tooth loss: a preliminary quantitative study. Br Dent J. 2000;188(9):503–6.PubMed
13.
go back to reference Glick MBP, Danik J. Severe caries and use of protease inhibitors. J Dent Res. 1998;77(Supplement):84. Glick MBP, Danik J. Severe caries and use of protease inhibitors. J Dent Res. 1998;77(Supplement):84.
14.
15.
go back to reference Guo L, Shi W. Salivary biomarkers for caries risk assessment. Journal of the California Dental Association. 2013;41(2):107–9 112-108.PubMedPubMedCentral Guo L, Shi W. Salivary biomarkers for caries risk assessment. Journal of the California Dental Association. 2013;41(2):107–9 112-108.PubMedPubMedCentral
16.
go back to reference Rezaei-Soufi L, Davoodi P, Abdolsamadi HR, Jazaeri M, Malekzadeh H. Dental caries prevalence in human immunodeficiency virus infected patients receiving highly active anti-retroviral therapy in Kermanshah Iran. Cell journal. 2014;16(1):73–8.PubMedPubMedCentral Rezaei-Soufi L, Davoodi P, Abdolsamadi HR, Jazaeri M, Malekzadeh H. Dental caries prevalence in human immunodeficiency virus infected patients receiving highly active anti-retroviral therapy in Kermanshah Iran. Cell journal. 2014;16(1):73–8.PubMedPubMedCentral
17.
go back to reference Carr A, Hoy J. Low bone mineral density with tenofovir: does statistically significant mean clinically significant? Clinical infectious diseases. 2010;51(8):973–5.CrossRefPubMed Carr A, Hoy J. Low bone mineral density with tenofovir: does statistically significant mean clinically significant? Clinical infectious diseases. 2010;51(8):973–5.CrossRefPubMed
18.
go back to reference Iwen F, Grigsby LP, Mansky LM, Gopalakrishnan R, Mansky KC. Tenofovir-associated bone density loss. Ther Clin Risk Manag. 2010;6:41–7. Iwen F, Grigsby LP, Mansky LM, Gopalakrishnan R, Mansky KC. Tenofovir-associated bone density loss. Ther Clin Risk Manag. 2010;6:41–7.
19.
go back to reference Post FA, Hamzah L, Fox J. Tenofovir disoproxil fumarate–associated bone loss: does vitamin D–binding protein play a role? AIDS. 2017;31(1):178–9.CrossRefPubMed Post FA, Hamzah L, Fox J. Tenofovir disoproxil fumarate–associated bone loss: does vitamin D–binding protein play a role? AIDS. 2017;31(1):178–9.CrossRefPubMed
20.
go back to reference Guerri-Fernandez R, Villar-Garcia J, Diez-Perez A, Prieto-Alhambra D. HIV infection, bone metabolism, and fractures. Arquivos brasileiros de endocrinologia e metabologia. 2014;58(5):478–83.CrossRefPubMed Guerri-Fernandez R, Villar-Garcia J, Diez-Perez A, Prieto-Alhambra D. HIV infection, bone metabolism, and fractures. Arquivos brasileiros de endocrinologia e metabologia. 2014;58(5):478–83.CrossRefPubMed
Metadata
Title
Extensive dental caries in a HIV positive adult patient on ART; case report and literature review
Authors
Dunstan Kalanzi
Harriet Mayanja-Kizza
Damalie Nakanjako
Nelson K. Sewankambo
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2018
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-018-0675-3

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