Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis

Abstract Objective To evaluate the evidence regarding the association between antiretroviral therapy and dental caries in children and adolescents with HIV. Methods Searches were conducted in five international databases (PubMed, Scopus, EMBASE, CENTRAL, and LILACS) from the inception of records up...

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Main Authors: Rubén Aguirre-Ipenza, Anthony Bautista-Pariona, Yolanda Viguria-Chavez, Alejandro Hector Huapaya-Cabrera, Franz Tito Coronel-Zubiate, Sara Antonieta Luján-Valencia, Elda Amaya-Riveros, Heber Isac Arbildo-Vega
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06015-0
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author Rubén Aguirre-Ipenza
Anthony Bautista-Pariona
Yolanda Viguria-Chavez
Alejandro Hector Huapaya-Cabrera
Franz Tito Coronel-Zubiate
Sara Antonieta Luján-Valencia
Elda Amaya-Riveros
Heber Isac Arbildo-Vega
author_facet Rubén Aguirre-Ipenza
Anthony Bautista-Pariona
Yolanda Viguria-Chavez
Alejandro Hector Huapaya-Cabrera
Franz Tito Coronel-Zubiate
Sara Antonieta Luján-Valencia
Elda Amaya-Riveros
Heber Isac Arbildo-Vega
author_sort Rubén Aguirre-Ipenza
collection DOAJ
description Abstract Objective To evaluate the evidence regarding the association between antiretroviral therapy and dental caries in children and adolescents with HIV. Methods Searches were conducted in five international databases (PubMed, Scopus, EMBASE, CENTRAL, and LILACS) from the inception of records up to October 2024, including studies that examine the impact of antiretroviral therapy on caries in individuals under 18 years of age. The risk of bias was assessed using the Newcastle–Ottawa Scale. Quantitative synthesis was performed using the inverse variance method or Mantel–Haenszel method, depending on the type of outcome analyzed. Measures of association included odds ratios and mean differences, employing a random-effects model with a 95% confidence interval. Results A total of 585 studies were identified, of which 17 were selected for qualitative review and 15 were included in the meta-analysis. The meta-analysis revealed a significantly higher risk of dental caries in children and adolescents with HIV undergoing antiretroviral therapy compared to those without the virus (odds ratio of 2.11; 95% CI: 1.41–3.17). Subgroup analysis showed a stronger association in case–control studies and for the DMFT index. The certainty of the evidence according to GRADE was rated as very low. Conclusion Despite limited certainty, the results suggest that HIV under antiretroviral therapy is associated with a higher risk of dental caries. It is prudent to interpret these results with caution, considering the methodological limitations of the studies. However, given the possible relevance of this association for public health, it is recommended to consider specific dental care protocols for children and adolescents with HIV, as well as the need for preventive strategies integrated into HIV management.
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spelling doaj-art-2520f6092e1a433bb5cccecb349de43c2025-08-20T02:15:15ZengBMCBMC Oral Health1472-68312025-05-0125112410.1186/s12903-025-06015-0Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysisRubén Aguirre-Ipenza0Anthony Bautista-Pariona1Yolanda Viguria-Chavez2Alejandro Hector Huapaya-Cabrera3Franz Tito Coronel-Zubiate4Sara Antonieta Luján-Valencia5Elda Amaya-Riveros6Heber Isac Arbildo-Vega7Faculty of Health Sciences, Universidad ContinentalFaculty of Human Medicine, Universidad Nacional del SantaSchool of Public Health, Universidad Peruana Cayetano HerediaFaculty of Health Sciences, Universidad Privada del NorteInstituto Privado de Estadística e Investigación en SaludFaculty of Dentistry, Dentistry School, Universidad Católica de Santa MaríaInstitute of Government and Public Management, Universidad de San Martín de PorresFaculty of Dentistry, Dentistry School, Universidad de San Martín de PorresAbstract Objective To evaluate the evidence regarding the association between antiretroviral therapy and dental caries in children and adolescents with HIV. Methods Searches were conducted in five international databases (PubMed, Scopus, EMBASE, CENTRAL, and LILACS) from the inception of records up to October 2024, including studies that examine the impact of antiretroviral therapy on caries in individuals under 18 years of age. The risk of bias was assessed using the Newcastle–Ottawa Scale. Quantitative synthesis was performed using the inverse variance method or Mantel–Haenszel method, depending on the type of outcome analyzed. Measures of association included odds ratios and mean differences, employing a random-effects model with a 95% confidence interval. Results A total of 585 studies were identified, of which 17 were selected for qualitative review and 15 were included in the meta-analysis. The meta-analysis revealed a significantly higher risk of dental caries in children and adolescents with HIV undergoing antiretroviral therapy compared to those without the virus (odds ratio of 2.11; 95% CI: 1.41–3.17). Subgroup analysis showed a stronger association in case–control studies and for the DMFT index. The certainty of the evidence according to GRADE was rated as very low. Conclusion Despite limited certainty, the results suggest that HIV under antiretroviral therapy is associated with a higher risk of dental caries. It is prudent to interpret these results with caution, considering the methodological limitations of the studies. However, given the possible relevance of this association for public health, it is recommended to consider specific dental care protocols for children and adolescents with HIV, as well as the need for preventive strategies integrated into HIV management.https://doi.org/10.1186/s12903-025-06015-0Antiretroviral therapyDental cariesChildrenHIVOral healthSystematic review
spellingShingle Rubén Aguirre-Ipenza
Anthony Bautista-Pariona
Yolanda Viguria-Chavez
Alejandro Hector Huapaya-Cabrera
Franz Tito Coronel-Zubiate
Sara Antonieta Luján-Valencia
Elda Amaya-Riveros
Heber Isac Arbildo-Vega
Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis
BMC Oral Health
Antiretroviral therapy
Dental caries
Children
HIV
Oral health
Systematic review
title Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis
title_full Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis
title_fullStr Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis
title_full_unstemmed Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis
title_short Association between antiretroviral therapy and dental caries in children and adolescents with HIV: a systematic review and meta-analysis
title_sort association between antiretroviral therapy and dental caries in children and adolescents with hiv a systematic review and meta analysis
topic Antiretroviral therapy
Dental caries
Children
HIV
Oral health
Systematic review
url https://doi.org/10.1186/s12903-025-06015-0
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