Impact of periodontal intervention on local inflammation, periodontitis, and HIV outcomes.
OBJECTIVE
The aim of this study was to determine active periodontal disease status in HIV and to determine the impact of periodontal disease resolution on HIV status.


METHODS
In this longitudinal cohort study, 73 HIV-positive subjects received comprehensive dental care. AAP, CDC/AAP, and BGI case definitions determined periodontal classification. Likelihood and frequency of moderate/severe periodontal disease were assessed based on demographic variables. The influence of periodontal intervention was assessed at baseline, 12, and 24 months. IL-6 was measured in a subset of subjects.


RESULTS
Of the periodontal classifications, BGI demonstrated the highest percentage category improvement with the intervention (>50%). Moderate/severe periodontitis was positively associated with HIV regardless of race, smoking status, gender, income level, and age, and was associated with increased IL-6. At baseline, the majority of subjects had severe periodontal disease regardless of ART status. Subjects with suppressed viral load at baseline demonstrated a significant improvement in BGI classification (P = 0.026), increased CD4 counts (P = 0.027), and decreased IL-6 levels (P = 0.03).


CONCLUSIONS
Periodontal inflammation was prevalent regardless of ART status. In virologically suppressed subjects, the intervention decreased periodontitis with a concomitant IL-6 decrease and CD4 increase. These findings suggest a relationship between periodontal inflammation, oral microbial translocation, and HIV status.
Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J
J
Valentine
Department of Dental Research, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
T
T
Saladyanant
Department of Dental Research, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
K
K
Ramsey
Department of Dental Research, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J
J
Blake
Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
T
T
Morelli
MeHarry School of Dentistry, Medical College, Nashville, TN, USA.
J
J
Southerland
Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
E B
EB
Quinlivan
Department of Dental Research, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
C
C
Phillips
Department of Microbiology and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Jae
J
Nelson
Department of Microbiology and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
K
K
DeParis
Department of Microbiology and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J
J
Webster-Cyriaque
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D010510:Periodontal Diseases / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism; D012720:Severity of Illness Index; D019562:Viral Load
D044966:Anti-Retroviral Agents; D015850:Interleukin-6
HIV; inflammation; microbial translocation; periodontal disease