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

Oral Dis. 2016 Apr;22 Suppl 1(Suppl 1):87-97. doi: 10.1111/odi.12419.

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.

Keywords: HIV; inflammation; microbial translocation; periodontal disease.

Publication types

  • Multicenter Study

MeSH terms

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

Substances

  • Anti-Retroviral Agents
  • Interleukin-6