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Original Research

Open Access

Prevalence and associated factors of enamel developmental defects among Nigerian children with perinatal HIV exposure

  • Nonso Emmanuel Onyia1
  • Paul Akhigbe2
  • Esosa Osagie2
  • Ozoemene Obuekwe3
  • Augustine Omoigberale4
  • Vincent P. Richards5,†
  • Modupe O. Coker2,6,*,†,
  • DOMHaIN Study team

1Department of Oral Pathology and Medicine, University of Benin, 302001 Edo State, Nigeria

2Research Department, Institute of Human Virology, Nigeria, 900107 Abuja, Nigeria

3Department of Oral and Maxillofacial Surgery, University of Benin, 300213 Benin City, Nigeria

4Child Health Department, University of Benin, 300213 Benin City, Nigeria

5Department of Biological Sciences, Clemson University, Clemson, SC 29631, USA

6Department of Oral Biology, Rutgers University, Newark, NJ 07103, USA

DOI: 10.22514/jocpd.2023.007 Vol.47,Issue 2,March 2023 pp.1-9

Submitted: 29 August 2022 Accepted: 22 November 2022

Published: 03 March 2023

*Corresponding Author(s): Modupe O. Coker E-mail:

† These authors contributed equally.


To evaluate the prevalence and pattern of developmental defects of the enamel (DDE) and their risk factors among children born infected with Human Immunodeficiency Virus (HIV) and those born to HIV-infected mothers compared with their unexposed counterparts (i.e., children born to uninfected mothers). This was an analytic cross-sectional study evaluating the presence and pattern of distribution of DDE in three groups of school-aged children (age, 4–11 years) receiving care and treatment at a Nigerian tertiary hospital, comprising: (1) HIV-infected (HI) on antiretroviral therapy (ART)(n = 184), (2) HIV-exposed but uninfected (HEU) (n = 186) and (3) HIV-unexposed and uninfected (HUU) (n = 184). Data capture forms and questionnaires were used to record the children’s medical and dental history based on clinical chart review and recall from their parents/guardians. Dental examinations were performed by calibrated dentists blinded to the study grouping. CD4+ (Cluster of Differentiation) T-cell counts were assayed for all participants. The diagnosis of DDE corresponded with the codes enumerated in the World Dental Federation’s modified DDE Index. Analyses relied on comparative statistics to determine risk factors associated with DDE. A total of 103 participants distributed among the three groups presented with at least one form of DDE, which indicated a prevalence of 18.59%. The HI group had the highest frequency of DDE-affected teeth (4.36%), while that of the HEU and HUU groups were 2.73%and 2.05%, respectively. Overall, the most encountered DDE was code 1 (Demarcated Opacity), accounting for 30.93% of all codes. DDE codes 1, 4 and 6 showed significant associations with the HI and HEU groups in both dentitions (p < 0.05). We found no significant association DDE and either very low birth weight or preterm births. A marginal association with CD4+ lymphocyte count was observed in HI participants. DDE is prevalent in school-aged children, and HIV infection is a significant risk factor for hypoplasia, a common form of DDE. Our results were consistent with other research linking controlled HIV (with ART) to oral diseases and reinforce advocacies for public policies targeted at infants exposed/infected perinatally with HIV.


HIV; Enamel; Opacity; Pediatric; Defects

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Nonso Emmanuel Onyia,Paul Akhigbe,Esosa Osagie,Ozoemene Obuekwe,Augustine Omoigberale,Vincent P. Richards,Modupe O. Coker,DOMHaIN Study team. Prevalence and associated factors of enamel developmental defects among Nigerian children with perinatal HIV exposure. Journal of Clinical Pediatric Dentistry. 2023. 47(2);1-9.


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