Periodontal disease in HIV-positive individuals: association of periodontal indices with stages of HIV disease.
BACKGROUND
Periodontal disease has been previously associated with human immunodeficiency virus (HIV) infection, and HIV infection has been considered a modifier of periodontal disease. The aim of this study was to report the prevalence and severity of periodontal disease in a population of HIV-positive individuals and to investigate the association between clinical periodontal indices and the stage of HIV disease, as expressed by CD4 cell counts.


METHODS
Thirty-nine male HIV-positive patients were recruited and a medical history was taken. To evaluate periodontal disease, probing depth (PD), attachment level loss (AL), bleeding index (BI), and modified gingival index (MGI) were recorded. Associations between the above indices and CD4 counts were examined.


RESULTS
Immunocompromised patients (with CD4 cell counts < 200 cells/microl) showed significantly lower BI and fewer sites with PD and AL > 4 mm compared to patients with CD4 cell counts > 200 cells/microl. When patients with CD4 counts < 500 cells/microl were considered alone, a correlation was observed between CD4 cell counts and BI (r2 = 0.1617, P = 0.0463), MGI (r2 = 0.2123, P = 0.0204), and number of sites with AL > 4 mm (r2 = 0.1469, P = 0.056).


CONCLUSIONS
Severely immunocompromised HIV-positive patients showed less severe gingival inflammation than expected. Patients with CD4 cell counts > 500 cells/microl showed no association between CD4 cell count and periodontal indices.
Department of Periodontics, Louisiana State University School of Dentistry, New Orleans, LA 70119-9799, USA. svasta@lsuhsc.edu
Sotirios A
SA
Vastardis
Raymond A
RA
Yukna
Paul L
PL
Fidel
Janet E
JE
Leigh
Donald E
DE
Mercante
D000328:Adult; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005884:Gingival Hemorrhage / Q000145:classification; D005891:Gingivitis / Q000145:classification; D015658:HIV Infections / Q000145:classification / Q000150:complications; D006679:HIV Seropositivity / Q000145:classification / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010510:Periodontal Diseases / Q000145:classification / Q000150:complications*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification