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Evidence found and GRADE certainty

4,587 questions · 5,761 findings · 495 reviews

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No studies found 1,011 · 17.5%GRADE not reported 1,797 · 31.2%Very low 1,100 · 19.1%Low 1,052 · 18.3%Moderate 649 · 11.3%High 152 · 2.6%

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Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Mucosal (oral) hyperpigmentation · Children or adolescents

CLWH on ART had significantly higher prevalence of mucosal hyperpigmentation than healthy controls (pooled OR 20.35, 95% CI 3.86 to 107.39); the authors described the certainty as low.

1 finding from 1 review

ART/HAART duration <3 years vs ART/HAART duration >=3 years

Other orofacial opportunistic infections (linear gingival erythema, hairy leukoplakia, angular cheilitis, oral ulcers) · Children and adolescents living with HIV on ART/HAART

ART/HAART duration had minimal influence on the prevalence of orofacial opportunistic infections other than candidiasis (no significant differences).

1 finding from 1 review
  • Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
    Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · ART/HAART duration <3 years vs >=3 years
    Except for candidiasis, no significant differences in the prevalence of opportunistic infection manifestations (linear gingival erythema, hairy leukoplakia, angular cheilitis, oral ulcers) between ART duration <3 years…
    2 studies
    GRADE not reported

Atraumatic restorative treatment vs placebo

Oral health-related quality of life · Children with dental caries

ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).

3 findings from 1 review

CD4+ T-cell count below 250 cells/mm3

HIV-related oral lesions · Children living with HIV receiving ART

One reported study did not show a clear difference in HIV-related oral lesions for children with CD4+ T-cell counts below 250 cells/mm3.

2 findings from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Recurrent oral ulcerations (WHO clinical stage 2) · Children or adolescents

CLWH on ART had significantly higher prevalence of recurrent oral ulcerations than healthy controls (pooled OR 6.83, 95% CI 1.18 to 39.53).

1 finding from 1 review

Combined antiretroviral therapy (post-cART) vs Pre-cART (same children, before therapy)

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Oral candidiasis prevalence fell significantly after cART compared with before cART in the same children (very low certainty).

1 finding from 1 review

Placebo vs Silver diamine fluoride

Oral health-related quality of life · Children with dental caries

The direct estimate found no statistically significant difference in oral health-related quality of life between placebo and silver diamine fluoride.

2 findings from 1 review

Antiretroviral therapy (any, including cART) vs No antiretroviral medication (treatment-naive)

Oral hygiene · Children and adolescents (<18 years) living with HIV (CLWH)

Oral hygiene status did not differ significantly between CLWH with and without ART (very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo

Oral health-related quality of life · Children with dental caries

SDF did not significantly differ from placebo for oral health-related quality of life in children (MD 0.03, 95% CI -0.16 to 0.22; ungraded).

1 finding from 1 review

Atraumatic restorative treatment plus fluoride varnish vs Silver diamine fluoride plus fluoride varnish

Oral health-related quality of life · Children with dental caries

The direct estimate found no statistically significant difference in oral health-related quality of life between atraumatic restorative treatment plus fluoride varnish and silver diamine fluoride plus fluoride varnish.

2 findings from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

Oral health-related quality of life · Children with dental caries

SDF did not significantly differ from atraumatic restorative treatment for oral health-related quality of life (MD 0.02, 95% CI -0.32 to 0.36; ungraded).

1 finding from 1 review

Combined antiretroviral therapy (cART) vs Monotherapy or dual antiretroviral therapy

Recurrent oral ulceration prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

No significant difference in recurrent oral ulceration between ART regimens (very low certainty).

1 finding from 1 review

CD4+ T-cell count below 250 cells/mm3 vs CD4+ T-cell count >=250 cells/mm3

HIV-related oral lesions · Children and adolescents living with HIV on ART/HAART

Lower CD4+ counts (<250 cells/mm3) were associated with roughly twice the odds of HIV-related oral lesions in two studies (not pooled).

1 finding from 1 review
  • Oral Health Status of Children and Adolescents Living with HIV Undergoing Antiretroviral Therapy: A Systematic Review… 2022 All outcomes
    Cross-sectional (case-control; single time point) · HIV pediatric/ART clinics, AIDS centers, and hospitals in Brazil, India, Saudi Arabia, and West Africa (Cote d'Ivoire, Mali, Senegal) · CD4+ T-cell count <250 cells/mm3 vs higher
    CLWH with CD4+ <250 cells/mm3 were about twice as likely to have HIV-related oral lesions: Baghirath 2013 OR 1.916 (95% CI 0.613 to 2.513), p=0.001; Divakar 2015 OR 1.999 (95% CI 0.129 to 3.688), p=0.001. Not pooled.
    2 studies
    GRADE not reported

Atraumatic restorative treatment vs Silver diamine fluoride

Oral health-related quality of life · Children with dental caries

The network estimate found no statistically significant difference in oral health-related quality of life between atraumatic restorative treatment and silver diamine fluoride.

2 findings from 1 review

Combined antiretroviral therapy (cART) vs No antiretroviral medication (treatment-naive)

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

cART was associated with a significantly lower prevalence of oral candidiasis in CLWH (very low certainty).

1 finding from 1 review

Monotherapy or dual antiretroviral therapy vs No antiretroviral medication (treatment-naive)

Oral candidiasis prevalence · Children and adolescents (<18 years) living with HIV (CLWH)

Oral candidiasis prevalence did not differ significantly between treatment-naive CLWH and those on monotherapy or dual therapy (very low certainty).

1 finding from 1 review

Living with HIV and undergoing antiretroviral therapy (ART/HAART) vs Healthy HIV-negative controls

Poor (inadequate) oral hygiene (prevalence) · Children or adolescents

No significant difference in oral hygiene between CLWH on ART and healthy controls (OR 1.23, 95% CI 0.73 to 2.07; single study).

1 finding from 1 review

Silver diamine fluoride (SDF) plus fluoride varnish vs Atraumatic restorative treatment + fluoride varnish (ART+FV)

Oral health-related quality of life · Children with dental caries

SDF plus fluoride varnish did not significantly differ from ART plus fluoride varnish for oral health-related quality of life (MD 0.16, 95% CI -0.1 to 0.42; ungraded).

1 finding from 1 review

ART/HAART duration <3 years vs ART/HAART duration >=3 years

Oral candidiasis · Children and adolescents living with HIV on ART/HAART

Oral candidiasis prevalence differed by ART duration (OR 17.93, 95% CI 3.69 to 83.12).

1 finding from 1 review