Chlorhexidine efficacy to control candida and gingivitis in HIV+ children

Objective: This study investigated the effect of chlorhexidine gel 0.2% on gingivitis and Candida ssp in HIV-infected children and correlated these results with CD4% and use of anti-retroviral therapy (AVT). Methods: 27 children were included based on positive oral culture for Candida. Children were instructed to brush the teeth 3 times/day for 21 days with chlorhexidine gel 0.2%. Oral exam, salivary samples, biofilm and gingival index were collected on baseline and 21 days after. Colony-forming units (CFU) were determined before and after chlorhexidine treatment on CHROmagar candida. The effect of chlorhexidine 0.2% on gingivitis and Candida ssp was correlated with CD4% and AVT(Spearman Correlation). Results: All children were positive-culture for Candida and 26 presented gingivitis. After 21 days of chlorhexidine therapy, Candida and gingivitis decreased in 25 and 26 children and was undetectable in 7 and 9, respectively. However, Candida's counts increased in 2 children from 51 to 91 CFU and from 2 to 9 CFU. The mean value for percentual reduction was 67.91% (S.D.43,51) for Candida and 73.64% (S.D.79,99) for gingivitis, and this reduction was statistically significant (Wilcoxon test; p<0.001). The average pre and post treatment mean CFU was 131.52 (S.D. 174.68, minimum 2 and maximum 691) and 45.70 (S.D. 79.22, minimum 0 and maximum 376), respectively. The mean percentual of pre-treatment gingivitis site was 45.70% (S.D.20.74, minimum 0 and maximum 72.4%) and post treatment, 7.25% (S.D. 7.25%, minimum 0 and maximum 22,8%). No correlation was observed between reduction and the use of AVT and CD4% (Spearman Correlation; p>0.05). Conclusion: Chlorhexidine gel 0.2% significantly reduced Candida ssp and gingivitis in HIV-infected children after 21 days-therapy. There was no correlation with AVT and CD4%. It should be suggested that this 0.2% chlorhexidine gel therapy may be an option for treatment and prevention of oral candidiasis and gingivitis on HIV+ children.