Impact of periodontal intervention on local inflammation, periodontitis, and HIV outcomes.

Abstract

OBJECTIVE:

The aim of this study was to determine active periodontal disease status in HIV and to determine the impact of periodontal disease resolution on HIV status.

METHODS:

In this longitudinal cohort study, 73 HIV-positive subjects received comprehensive dental care. AAP, CDC/AAP, and BGI case definitions determined periodontal classification. Likelihood and frequency of moderate/severe periodontal disease were assessed based on demographic variables. The influence of periodontal intervention was assessed at baseline, 12, and 24 months. IL-6 was measured in a subset of subjects.

RESULTS:

Of the periodontal classifications, BGI demonstrated the highest percentage category improvement with the intervention (>50%). Moderate/severe periodontitis was positively associated with HIV regardless of race, smoking status, gender, income level, and age, and was associated with increased IL-6. At baseline, the majority of subjects had severe periodontal disease regardless of ART status. Subjects with suppressed viral load at baseline demonstrated a significant improvement in BGI classification (P = 0.026), increased CD4 counts (P = 0.027), and decreased IL-6 levels (P = 0.03).

CONCLUSIONS:

Periodontal inflammation was prevalent regardless of ART status. In virologically suppressed subjects, the intervention decreased periodontitis with a concomitant IL-6 decrease and CD4 increase. These findings suggest a relationship between periodontal inflammation, oral microbial translocation, and HIV status.

• Authors: J Valentine, T Saladyanant, K Ramsey, J Blake, T Morelli, J Southerland, E B Quinlivan, C Phillips, Jae Nelson, K DeParis, J Webster-Cyriaque
• Journal: Oral diseases (Oral Dis) Vol. 22 Suppl 1 Pg. 87-97 (Apr 2016) ISSN: 1601-0825 [Electronic] Denmark
• PMID: 27109277 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Anti-Retroviral Agents
• Interleukin-6

Topics

• Adult
• Anti-Retroviral Agents (therapeutic use)
• CD4 Lymphocyte Count
• Female
• HIV Infections (blood, complications, drug therapy, metabolism)
• Humans
• Inflammation (metabolism)
• Interleukin-6 (metabolism)
• Longitudinal Studies
• Male
• Periodontal Diseases (complications, metabolism, therapy)
• Prospective Studies
• Saliva (metabolism)
• Severity of Illness Index
• Viral Load