Oral microbiome and HIV in early childhood caries. Community disruptions in the oral microbiome of children living with HIV in early childhood caries development

Children living with HIV (CLWH) have a higher prevalence of oral diseases including early childhood caries (ECC). Here we test the hypothesis that CLWH have a more cariogenic dental microbiome than unexposed children. We collected supragingival plaques from 484 children representing three exposure groups and six dental health categories. We found that the microbiome of CLWH is distinct as compared to exposed or unexposed children, and that this distinction is more pronounced in diseased teeth, suggesting the impact of HIV is more severe as ECC progresses. Moreover, we report both an increase in bacterial diversity and decrease in community similarity as CLWH age, which may in part be a prolonged effect of HIV and/or treatment. Our results suggest that broad and increasingly individualistic ecological shifts are responsible for the pathogenesis of ECC in CLWH coupled with a diverse and possibly severe impact on known cariogenic taxa that potentially exacerbates caries.