title: Necrotizing periodontal diseases in HIV-infected Brazilian patients: a clinical and microbiologic descriptive study.
abstract: OBJECTIVE
  Nowadays, necrotizing periodontal diseases have a low prevalence; however, a better understanding of the etiopathogenesis of these diseases is necessary for determining more adequate preventive and therapeutic strategies.
  
  
  METHODS
  From a pool of 1,232 HIV-infected patients, 15 presented with necrotizing periodontal diseases, which were evaluated by full-mouth periodontal clinical measurements. Subgingival biofilm samples were collected from necrotizing lesions of six of these individuals. The presence and levels of 47 bacterial species were determined by checkerboard DNA-DNA hybridization.
  
  
  RESULTS
  All 15 patients (10 had severe immunodeficiency) had been infected sexually. Thirteen patients were taking antiretroviral medication (66.7% undergoing highly active antiretroviral therapy). Regarding necrotizing periodontal diseases, necrotizing ulcerative gingivitis (60%) was more prevalent than necrotizing ulcerative periodontitis (40%). The frequency of supragingival biofilm and bleeding on probing ranged from 11.5% to 59.2% and 3.0% to 54.0%, respectively, whereas the mean probing depth and clinical attachment level were between 1.48 and 2.61 mm and 1.30 and 2.62 mm, respectively. Species detected in high prevalence and/or counts in necrotizing lesions included Treponema denticola, Eikenella corrodens, Dialister pneumosintes, Enterococcus faecalis, Streptococcus intermedius, Aggregatibacter actinomycetemcomitans, and Campylobacter rectus. In contrast, Parvimonas micra, Prevotella melaninogenica, Fusobacterium nucleatum, Eubacterium nodatum, and Helicobacter pylori were observed in the lowest mean prevalence and/or counts.
  
  
  CONCLUSIONS
  Necrotizing periodontal disease lesions in HIV-infected patients present a microbiota with high prevalence and/or counts of classical periodontal pathogens, in particular T denticola, as well as species not commonly considered as periodontal pathogens, such as E faecalis and D pneumosintes. In addition, these individuals with necrotizing periodontal disease frequently display severe immunodeficiency and AIDS-defining diseases such as tuberculosis.
authors.affiliation: Department of Periodontology, Brazilian Navy, Rio de Janeiro, Brazil.
authors.forename: Meyrelane Pereira de Almeida
authors.initials: MP
authors.lastname: Ramos
authors.forename: Sonia Maria Soares
authors.initials: SM
authors.lastname: Ferreira
authors.forename: Carina M
authors.initials: CM
authors.lastname: Silva-Boghossian
authors.forename: Renata
authors.initials: R
authors.lastname: Souto
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Colombo
authors.forename: Cesar Werneck
authors.initials: CW
authors.lastname: Noce
authors.forename: Lucio de Souza
authors.initials: LS
authors.lastname: Gonçalves
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018441:Biofilms; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology*; D005260:Female; D005892:Gingivitis, Necrotizing Ulcerative / Q000150:complications* / Q000382:microbiology*; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D058889:Molecular Typing; D010512:Periodontal Index; D010518:Periodontitis / Q000150:complications / Q000382:microbiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents