Oral manifestations of HIV positive children The Journal of Clinical Pediatric Dentistry Volume 25, Number 2/2000 103 INTRODUCTION I n the city of Sao Paulo, epidemiological data indi- cate that HIV infection has been spreading and is now an important cause of death in the pediatric group. In Brazil, the first pediatric case of aids occurred in 1983. In 1990 there were 313 notified cases, and nowadays, 10 years later, the number of children living with aids is 762. Among them, 84% were infected through the vertical route. The second transmission route occurs through cont- aminated needles, which are utilized by drug users, fol- lowed by sexual transmission. Because in most coun- tries the vertical route is the most important one, sev- eral studies have evaluated protocols that reduce this transmission risk. Connor 1 demonstrated that an early treatment of seropositive pregnant mothers with Zidovudine (AZT) reduces chances of transmission to babies to 8% from 25%. Other studies have shown that Vitamin A supple- menting prevents perinatal transmission and reduces morbidity from many complications associated with the HIV infection. 2, 3 HIV infection progression is faster and more severe in children, due to the immaturity of the immune sys- tem. Its clinical course can be described with a bimodal curve, where approximately 25% of infected children develop AIDS in their first year of life, with a rapid pro- gression of the disease.The remaining 75% develop the disease later and slowly. 4, 5 Orofacial manifestations are among the earliest and most common clinical signs of pediatric HIV disease. They are considered prognosis indicators for the dis- ease.Thus, several authors demonstrated that the pres- ence of oral candidiasis in children indicates a poor prognosis. Parotid gland enlargement is indicative of a better prognosis or long term survival. 5-7 The purpose of this study was to determine the prevalence of oral manifestations associated with pedi- atric HIV infection in Brazilian children, seen at Spe- cial Care Dentistry Center (SCDC), School of Den- tistry of the University of Sao Paulo. PATIENTS AND METHODS Thirty-eight HIV positive children aged 2 to 13 years old, receiving routine dental care at the SCDC, were examined. Data obtained from medical past history, clinical examination and complementary exams were transcribed to an application form, especially designed for this study. Data such as age, racial group, route of HIV trans- mission, signs and symptoms associated with HIV/Aids, opportunistic diseases, oral diseases, and antiretroviral therapy were collected. Physical examination included also palpating sub- mandibular and retroauricular cervical areas, palpating Oral manifestations of HIV positive children Marina Gallottini Magalhães* / Daniela Franco Bueno** / Edna Serra*** / Rhoner Gonçalves**** Oral manifestations in HIV positive children were observed in thirty-eight HIV infected children that have received care at the Special Care Dentistry Center (SCDC) of the School of Dentistry, University of Sao Paulo. Results have shown that 52.63% of the children presented at least one oral manifestation related with HIV/AIDS. Angular cheilitis occurred in 28.94%, parotid gland bilateral enlargement, pseudomembranous candidiasis and erythematous candidiais in 18.42%, conventional gingivitis in 13.15%, herpes simplex in 5.26%, hairy leukoplakia, recurrent aphtous ulcer and condyloma acumi- natum in 2.63%. Although enamel hypoplasia occurred in 23.68%, this could not be attributed specif- ically to HIV infection. J Clin Pediatr Dent 25(2): 103-106, 2001 * Marina Gallottini Magalhães, DDS, MSc, PhD, Department of Oral Pathology, School of Dentistry- University of Sao Paulo, Sao Paulo, Brazil. ** Daniela Franco Bueno, DDS, Department of Oral Pathology, School of Dentistry- University of Sao Paulo, Sao Paulo, Brazil. *** Edna Serra, DDS, Department of Oral Pathology, School of Dentistry- University of Sao Paulo, Sao Paulo, Brazil. **** Rhoner Gonçalves, DDS, Department of Oral Pathology, School of Dentistry- University of Sao Paulo, Sao Paulo, Brazil. Send all correspondence to Dr. M.H.C.G. Magalhães, Rua Filadelfo Aranha, 95, 05449-100 São Paulo- SP, Brazil e-mail: mhcgmaga@siso.fo.usp.br Downloaded from http://meridian.allenpress.com/jcpd/article-pdf/25/2/103/3034505/jcpd_25_2_f01k062j7315660v.pdf by Bharati Vidyapeeth Dental College & Hospital user on 01 July 2022