Date Published: August 29, 2012
Publisher: Hindawi Publishing Corporation
Author(s): Razia Khammissa, Liviu Feller, Mario Altini, Paul Fatti, Johan Lemmer.
The effect of HIV infection on the prevalence and the rate of progression of chronic periodontitis is not clear. The aim of this study was to compare parameters associated with the severity of chronic periodontitis in terms of periodontal probing depths, gingival recession, plaque indexes, and bleeding indexes of HIV-seropositive subjects and healthy age-matched control subjects, and of HIV-seropositive subjects on highly active antiretroviral therapy and those not receiving such treatment. Two cohorts of subjects with chronic periodontitis were recruited for this study over a period of six months. There were 30 HIV-seropositive subjects, and 30 control subjects. Periodontal probing depths, gingival marginal recession, plaque indexes, and bleeding indexes were compared by HIV serostatus, the use of highly active antiretroviral therapy, and CD4+ T-cell counts. All participants were black persons between the age of 18 and 45 and were of a similar socioeconomic status and age. The results of this study indicate that chronic periodontitis in HIV-seropositive subjects is similar in terms of mean periodontal probing depth, gingival marginal recession, plaque index, and bleeding index to that in healthy age-matched control subjects, and a low CD4+ T-cell count does not appear to be a risk factor for increased severity of chronic periodontitis.
The relationship between chronic periodontitis and HIV infection is not clear and considerable differences of opinion exist regarding the prevalence of chronic periodontitis among HIV-seropositive subjects [1, 2]. Microbiological studies have failed to detect any major differences in the subgingival microbial flora of HIV-seropositive subjects with chronic periodontitis compared to HIV-seronegative controls [3, 4], and the humoral immune response to the periodontopathic bacteria is similar in both groups .
The mean number of teeth per mouth of the group of HIV-seropositive subjects (29 teeth) and of the group of the control subjects (28 teeth) was similar. Periodontal probing depth (PPD), gingival recession (GR), plaque index (PI), and bleeding index (BI) were compared by HIV-serostatus, the use of HAART, and CD4+ T-cell counts. CD4+ T-cell counts were stratified into the following groups: CD4+ T-cell count <200 cells/mm3, CD4+ T-cell counts 200–500 cells/mm3, and CD4+ T-cell count >500 cells/mm3. HAART was defined as the use of at least two nucleoside reverse transcriptase inhibitors with either a nonnucleoside reverse transcriptase inhibitor or a protease inhibitor. All participants were black persons from the Ga-Rankuwa area in South Africa and were of a similar socioeconomic status and age. CD4+ T-cell counts were available for eight HIV-seropositive subjects using HAART and for five HAART-naïve subjects. There were only eight subjects that admitted to smoking.
This study demonstrates that both HIV-seropositive and apparently healthy subjects with chronic periodontitis have similar mean PPD, GR, PI, and BI measurements and that HIV infection does not carry with it a greater risk for accelerated periodontal attachment loss [2, 19]. This conforms with other studies that documented similar clinical manifestations and natural courses of chronic periodontitis in HIV-seropositive and -seronegative subjects [12, 13, 20, 21].
Chronic periodontitis in HIV-seropositive subjects is similar in terms of mean PPD, GR, PI, and BI to that in presumably healthy aged-matched control subjects, and a low CD4+ T-cell count does not appear to be a risk factor for increased frequency or severity of chronic periodontitis.