title: Route of transmission might influence the clinical expression of periodontal lesions in "human immunodeficiency virus" positive patients.
abstract: BACKGROUND
  Various routes have been reported with respect to the transmission of human immunodeficiency virus (HIV) from one individual to another. But it is not clear whether they alter the clinical expression of the disease. This study was conducted to know whether there exists any difference in the occurrence of periodontal lesions among untreated HIV subjects who acquired the disease either through intravenous drug abuse or sexual contact and to correlate those lesions with immune suppression as indicated by CD 4 T lymphocyte counts.
  
  
  METHODS
  In this cross-sectional study 213 HIV-positive subjects who had not started on Highly Active Anti Retroviral Therapy (HAART) were selected and divided into two groups intravenous drug users (IVDU) and non-IVDU (NIVDU). CD 4 T lymphocyte counts were evaluated and clinical examination was done to detect the presence of pathologic periodontal lesions.
  
  
  RESULTS
  Mean probing depth (PD) and clinical attachment level (CAL) are significantly higher in drug users than nondrug users. When periodontal lesions are compared with CD 4 cell counts, it is found that significant inverse relation exists between linear gingival erythema, necrotizing ulcerative periodontitis, and CD 4 counts, but only in nondrug users.
  
  
  CONCLUSIONS
  An inverse correlation between linear gingival erythema, necrotizing ulcerative periodontitis, and CD 4 counts in NIVDU indicating their reliability as a marker for immune suppression. Periodontitis is more prevalent among drug users indicating some difference in disease expression among the groups.
authors.affiliation: Department of Periodontics, Tamil Nadu Government Dental College, Chennai, India. vathathmaja@yahoo.co.in
authors.forename: A T
authors.initials: AT
authors.lastname: Ranganathan
authors.forename: P K
authors.initials: PK
authors.lastname: Saraswathi
authors.forename: V
authors.initials: V
authors.lastname: Albert
authors.forename: M G K
authors.initials: MG
authors.lastname: Baba
authors.forename: K H
authors.initials: KH
authors.lastname: Panishankar
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D015897:Comorbidity; D004890:Erythema / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000453:epidemiology*; D010518:Periodontitis / Q000453:epidemiology; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous