BMC Oral Health | |
Is human immunodeficiency virus (HIV) stage an independent risk factor for altering the periodontal status of HIV-positive patients? A South African study | |
Charlene Wilma Joyce Africa1  Lawrence Xavier Stephen2  Cathy Nisha John2  | |
[1] Anaerobe group, Department of Medical Biosciences, University of the Western Cape, Western Cape, South Africa;Department of Periodontics and Oral Medicine, University of the Western Cape, Western Cape, South Africa | |
关键词: Smoking; ART; HIV stage; Interdental aids; Brushing; Oral hygiene; Age; HIV-positive patients; Immunosuppression; CD4 + T cell counts; Periodontal disease; | |
Others : 1121531 DOI : 10.1186/1472-6831-13-69 |
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received in 2013-07-16, accepted in 2013-11-26, 发布年份 2013 | |
【 摘 要 】
Background
The immunosuppresion in HIV patients makes them highly susceptible to microbial infections. The aim of the study was to establish whether HIV stage (as depicted by CD4+ T lymphocyte counts) could independently be associated with periodontal status (as revealed by the measurement of clinical indices).
Methods
One hundred and twenty HIV-infected patients attending an infectious diseases clinic in the Western Cape, South Africa were included in the study. The periodontal clinical indices such as plaque index, gingival index, pocket probing depth and clinical attachment levels were measured on the mesial aspect of the six Ramfjord teeth. The CD4 + T cell counts were taken from the patients’ medical records and patients’ HIV stage determined and grouped according to their CD4+ T cell counts into A (<200 cells /mm3), B (200–500 cells /mm3) and C (>500 cells /mm3).
Results
The mean age of 120 HIV-positive patients was 33.25 years and the mean CD4 + T cell count was 293.43 cells/mm3. The probing depth and clinical attachment loss were found to be significantly associated with the total CD4 + T cell counts but not with HIV stage. Significant correlations were found between age and all clinical indices except for clinical attachment loss. No correlation was found between age and HIV stage of the patients. The use of antiretroviral therapy was significantly associated with probing depth and clinical attachment loss, but not with plaque nor gingival index. Significant associations were observed between smoking and all of the clinical indices except for the gingival index. A significant association was observed between the use of interdental aids and all the clinical indices except for probing depth, while brushing was significantly associated with plaque index only. CD4 + T cell counts were significantly associated with brushing frequency (p = 0.0190) and the use of interdental aids (p = 0.0170).
Conclusion
The findings of this study conclude that HIV stage, ART and age are not independent risk factors for changes in the periodontal status of HIV-positive subjects but rather that smoking and oral hygiene habits determine their susceptibility to disease.
【 授权许可】
2013 John et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150212024328947.pdf | 223KB | download | |
Figure 2. | 35KB | Image | download |
Figure 1. | 49KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]UNAIDS: UNAIDS report on the global AIDS epidemic 2013. Available: http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf webcite. UNAIDS, Geneva, Switzerland. [Accessed 28 November 2013]
- [2]Winkler JR, Robertson PB: Periodontal disease associated with HIV infection. Oral surgery, oral medicine, and oral pathology 1992, 73(2):145-150.
- [3]Robinson PG: The significance and management of periodontal lesions in HIV infection. Oral diseases 2002, 8(Suppl 2):91-97.
- [4]Mellors JW, Munoz A, Giorgi JV, Margolick JB, Tassoni CJ, Gupta P, Kingsley LA, Todd JA, Saah AJ, Detels R, et al.: Plasma viral load and CD4+ lymphocytes as prognostic markers of HIV-1 infection. Annals of internal medicine 1997, 126(12):946-954.
- [5]Kinane DF: Periodontitis modified by systemic factors. Annals of periodontology / the American Academy of Periodontology 1999, 4(1):54-64.
- [6]Ranganathan K, Reddy BV, Kumarasamy N, Solomon S, Viswanathan R, Johnson NW: Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients. Oral diseases 2000, 6(3):152-157.
- [7]Eyeson JD, Warnakulasuriya KA, Johnson NW: Prevalence and incidence of oral lesions–the changing scene. Oral diseases 2000, 6(5):267-273.
- [8]Umeda M, Chen C, Bakker I, Contreras A, Morrison JL, Slots J: Risk indicators for harboring periodontal pathogens. Journal of periodontology 1998, 69(10):1111-1118.
- [9]Tucker R: Periodontitis and pregnancy. The journal of the Royal Society for the Promotion of Health 2006, 126(1):24-27.
- [10]Loesche WJ, Grossman NS: Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clinical microbiology reviews 2001, 14(4):727-752. table of contents
- [11]Patton LL: Sensitivity, specificity, and positive predictive value of oral opportunistic infections in adults with HIV/AIDS as markers of immune suppression and viral burden. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 2000, 90(2):182-188.
- [12]Schmidt-Westhausen AM, Priepke F, Bergmann FJ, Reichart PA: Decline in the rate of oral opportunistic infections following introduction of highly active antiretroviral therapy. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology 2000, 29(7):336-341.
- [13]Gaitan Cepeda LA, Ceballos Salobrena A, Lopez Ortega K, Arzate Mora N, Jimenez Soriano Y: Medicina oral, patologia oral y cirugia bucal. 2008, 13(2):E85-E93.
- [14]Lindhe J: Epidemiology of periodontal disease. Clinical Periodontology and Implant dentistry, Volume 7 5th edition. 2008, 129-155.
- [15]Murray PA: HIV disease as a risk factor for periodontal disease. Compend Contin Ed Dent 1994, 15:1052-1064.
- [16]Barr C, Lopez MR, Rua-Dobles A: Periodontal changes by HIV serostatus in a cohort of homosexual and bisexual men. Journal of clinical periodontology 1992, 19(10):794-801.
- [17]Lewis DA: Antiretroviral combination therapy for HIV infection. Dental update 2003, 30(5):242-247.
- [18]John CN, Stephen LXG, Africa CWJ: BANA-Positive Plaque Samples Are Associated with Oral Hygiene Practices and Not CD4+ T Cell Counts in HIV-Positive Patients. International journal of dentistry 2012, 2012:157641.
- [19]Dowsett SA, Archila L, Segreto VA, Eckert GJ, Kowolik MJ: Periodontal disease status of an indigenous population of Guatemala, Central America. Journal of clinical periodontology 2001, 28(7):663-671.
- [20]Barmes D: CPITN–a WHO initiative. International dental journal 1994, 44(5 Suppl 1):523-525.
- [21]Rozra S, Kundu D, Saha B, Rudra A, Chakrabarty S, Bharati P: Periodontal status of HIV-infected patients with special reference to CD4 cell count in Western Bengal. India. Asian Pacific J Tropical Disease 2012, 2(6):470-474.
- [22]Fricke U, Geurtsen W, Staufenbiel I, Rahman A: Periodontal status of HIV-infected patients undergoing antiretroviral therapy compared to HIV-therapy naive patients: a case control study. European journal of medical research 2012, 17:2. BioMed Central Full Text
- [23]Stojkovic A, Boras VV, Planbak D, Lisic M, Srdjak S: Evaluation of periodontal status in HIV infected persons in Croatia. Collegium antropologicum 2011, 35(1):67-71.
- [24]Phiri R, Feller L, Blignaut E: The severity, extent and recurrence of necrotizing periodontal disease in relation to HIV status and CD4+ T cell count. J Int Acad Periodontol 2010, 12(4):98-103.
- [25]Vastardis SA, Yukna RA, Fidel PL Jr, Leigh JE, Mercante DE: Periodontal disease in HIV-positive individuals: association of periodontal indices with stages of HIV disease. Journal of periodontology 2003, 74(9):1336-1341.
- [26]Holmgren CJ, Corbet EF: Relationship between periodontal parameters and CPITN scores. Community dentistry and oral epidemiology 1990, 18(6):322-323.
- [27]Leroy R, Eaton KA, Savage A: Methodological issues in epidemiological studies of periodontitis–how can it be improved? BMC oral health 2010, 10:8. BioMed Central Full Text
- [28]Benigeri M, Brodeur JM, Payette M, Charbonneau A, Ismail AI: Community periodontal index of treatment needs and prevalence of periodontal conditions. Journal of clinical periodontology 2000, 27(5):308-312.
- [29]Baelum V, Fejerskov O, Manji F: Periodontal diseases in adult Kenyans. Journal of clinical periodontology 1988, 15(7):445-452.
- [30]Cutress TW, Ainamo J, Sardo-Infirri J: The community periodontal index of treatment needs (CPITN) procedure for population groups and individuals. International dental journal 1987, 37(4):222-233.
- [31]McKaig RG, Patton LL, Thomas JC, Strauss RP, Slade GD, Beck JD: Factors associated with periodontitis in an HIV-infected southeast USA study. Oral diseases 2000, 6(3):158-165.
- [32]Robinson PG, Sheiham A, Challacombe SJ, Zakrzewska JM: The periodontal health of homosexual men with HIV infection: a controlled study. Oral diseases 1996, 2(1):45-52.
- [33]Induchoodan A: Periodontal status in stages of HIV disease - A short-term clinical study. Perio 2008, 5(4):247-250.
- [34]Sontakke SA, Umarji HR, Karjodkar F: Comparison of oral manifestations with CD4 count in HIV-infected patients. Indian journal of dental research: official publication of Indian Society for Dental Research 2011, 22(5):732.
- [35]Mataftsi M, Skoura L, Sakellari D: HIV infection and periodontal diseases: an overview of the post-HAART era. Oral diseases 2011, 17(1):13-25.
- [36]Patton LL, McKaig R, Strauss R, Rogers D, Eron JJ Jr: Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 2000, 89(3):299-304.
- [37]Mulligan R, Phelan JA, Brunelle J, Redford M, Pogoda JM, Nelson E, Seirawan H, Greenspan JS, Navazesh M, Greenspan D, et al.: Baseline characteristics of participants in the oral health component of the Women’s Interagency HIV Study. Community dentistry and oral epidemiology 2004, 32(2):86-98.
- [38]Greenspan D, Gange SJ, Phelan JA, Navazesh M, Alves ME, MacPhail LA, Mulligan R, Greenspan JS: Incidence of oral lesions in HIV-1-infected women: reduction with HAART. Journal of dental research 2004, 83(2):145-150.
- [39]Bloom B, Adams PF, Cohen RA, Simile C: Smoking and oral health in dentate adults aged 18–64. NCHS data brief 2012, 85:1-8.
- [40]Yalcin F, Eskinazi E, Soydinc M, Basegmez C, Issever H, Isik G, Berber L, Has R, Sabuncu H, Onan U: The effect of sociocultural status on periodontal conditions in pregnancy. Journal of periodontology 2002, 73(2):178-182.
- [41]Bergstrom J, Preber H: Tobacco use as a risk factor. Journal of periodontology 1994, 65(5 Suppl):545-550.
- [42]Albandar JM, Streckfus CF, Adesanya MR, Winn DM: Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss. Journal of periodontology 2000, 71(12):1874-1881.
- [43]Calsina G, Ramon JM, Echeverria JJ: Effects of smoking on periodontal tissues. Journal of clinical periodontology 2002, 29(8):771-776.
- [44]VanDevanter N, Dorsen CG, Messeri P, Shelley D, Person A: Oral health care and smoking cessation practices of interprofessional home care providers for their patients with HIV. Journal of interprofessional care 2012, 26(4):339-340.
- [45]Jeganathan S, Batterham M, Begley K, Purnomo J, Houtzager L: Predictors of oral health quality of life in HIV-1 infected patients attending routine care in Australia. Journal of public health dentistry 2011, 71(3):248-251.
- [46]Tomar SL, Pereyra M, Metsch LR: Oral health-related quality of life among low-income adults living with HIV. J of public health dentistry 2011, 71(3):241-247.
- [47]Alves M, Mulligan R, Passaro D, Gawell S, Navazesh M, Phelan J, Greenspan D, Greenspan JS: Longitudinal evaluation of loss of attachment in HIV-infected women compared to HIV-uninfected women. J of periodontology 2006, 77(5):773-779.