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Sci Rep. 2019 Oct 10;9(1):14610. doi: 10.1038/s41598-019-51077-0.

Association of oral health status with the CD4+ cell count in children living with HIV in Phnom Penh, Cambodia.

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Institute of Decision Science for a Sustainable Society, Kyushu University, Fukuoka, Japan.
Section of Orthodontics, Kyushu University Hospital, Fukuoka, Japan.
KHANA Center for Population Health Research, Phnom Penh, Cambodia.
National Paediatric Hospital, Phnom Penh, Cambodia.
Center for Global Health Research, Touro University California, Vallejo, CA, USA.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.


The association between oral and overall health, and particularly between dental and immune health, in children living with HIV remains unclear. This study examined the association between the decayed, missing and filled teeth (DMFT) score and CD4+ cell counts in 142 children living with HIV aged 8-15 years (male, 51%) from Phnom Penh, Cambodia. Other indicators of oral health (e.g., debris index, salivary flow, salivary pH and oral health-related quality of life) and overall health (e.g., nutritional status and quality of life) were also evaluated. DMFT scores were negatively associated with the CD4+ cell count in male children (β: -0.13, 95% confidence interval [CI]: -0.25, -0.02). In all children, positive associations were observed between salivary pH and CD4+ count (β: -0.645, 95% CI: 0.02, 1.25) and between salivary flow and height-for-age Z-score (β: 1.22, 95% CI: 0.50, 1.95). The debris index was negatively associated with the height-for-age Z-score (β: -2.04, 95% CI: -3.38, -0.71). In summary, oral health was associated with immune and nutritional status. Oral health policies for children living with HIV should be emphasised, and further studies should evaluate the mechanism underlying the relationship between oral and overall health.

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