Factors associated with periodontitis in an HIV-infected southeast USA study.

OBJECTIVES To determine the relationship of immunosuppression with measures of probing pocket depth (PPD), recession (REC), and clinical attachment level (CAL) in an HIV-infected population from North Carolina (NC), a state in the southeastern United States (USA). DESIGN Cross-sectional study of HIV-infected adults (n = 326) treated at the University of North Carolina Hospitals. Clinical medical record review and sociodemographic interview data were collected. Median age of study participants was 37 years (range 19-67). Males comprised 78% and Blacks 60%. Analyses were limited to those who were dentate (n = 316). MAIN OUTCOME MEASURES Main outcomes were cases vs non-cases of notable PPD, REC, and CAL. Immunosuppression measured by CD4+ cell count microL was the exposure of interest. RESULTS Defined cases of PPD (n = 148) were 2.6 (95% CI = 1.3, 5.3) times less likely to occur at CD4+ cells < 200 than non-cases, whereas, cases of REC (n = 94) were 2.8 (95% CI = 1.2, 6.6) times more likely to occur at that level of severe immunosuppression, controlling for confounders. CONCLUSION Sub-groups of persons with HIV experience a high burden of periodontitis where notable severity and extent of PPD, CAL, and REC were clearly evident at different stages of immunosuppression.

[1]  L. Patton,et al.  Oral manifestations of HIV in a southeast USA population. , 2008, Oral diseases.

[2]  A. Sheiham,et al.  The periodontal health of homosexual men with HIV infection: a controlled study. , 2008, Oral diseases.

[3]  G. Slade,et al.  Prevalence of HIV-associated periodontitis and chronic periodontitis in a southeastern US study group. , 1998, Journal of public health dentistry.

[4]  M. Begg,et al.  New concepts regarding the pathogenesis of periodontal disease in HIV infection. , 1998, Annals of periodontology.

[5]  I. Lamster,et al.  Epidemiology and diagnosis of HIV-associated periodontal diseases. , 1997, Oral diseases.

[6]  R. Page,et al.  Risk assessment for periodontal diseases. , 1997, International dental journal.

[7]  R. Arnold,et al.  Inflammatory mediator response as a potential risk marker for periodontal diseases in insulin-dependent diabetes mellitus patients. , 1997, Journal of periodontology.

[8]  G. E. Oxford,et al.  Oral diseases, mycology and periodontal microbiology of HIV-1-infected women. , 1996, Oral microbiology and immunology.

[9]  R. Royce Human immunodeficiency virus-related morbidity and mortality in injection drug users: should the AIDS definition be changed yet again? , 1996, Epidemiology.

[10]  G. L. Smith,et al.  Comparison of periodontal disease in HIV seropositive subjects and controls (I). Clinical features. , 1995, Journal of clinical periodontology.

[11]  S. Tomar,et al.  Loss of periodontal attachment in HIV-seropositive military personnel. , 1995, Journal of periodontology.

[12]  M. Glick,et al.  Necrotizing ulcerative periodontitis: a marker for immune deterioration and a predictor for the diagnosis of AIDS. , 1994, Journal of periodontology.

[13]  M. Glick,et al.  Oral manifestations associated with HIV-related disease as markers for immune suppression and AIDS. , 1994, Oral surgery, oral medicine, and oral pathology.

[14]  G. Koch,et al.  Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. , 1994, Journal of periodontology.

[15]  J. Hilton,et al.  The diagnosis of periodontal conditions associated with HIV infection. , 1994, Journal of periodontology.

[16]  G. Stewart,et al.  Progression of periodontal disease in HIV seropositive patients. , 1993, Journal of periodontology.

[17]  L. Moore,et al.  The influence of race and gender on periodontal microflora. , 1993, Journal of periodontology.

[18]  C. Barr,et al.  Periodontal changes by HIV serostatus in a cohort of homosexual and bisexual men. , 1992, Journal of clinical periodontology.

[19]  S. Buchbinder,et al.  Periodontal disease in HIV-infected and uninfected homosexual and bisexual men. , 1992, AIDS.

[20]  M. Katz,et al.  Prevalence of HIV-associated periodontitis and gingivitis in HIV-infected patients attending an AIDS clinic. , 1992, Journal of acquired immune deficiency syndromes.

[21]  M. Cohen,et al.  Risk indicators for periodontitis in a military treatment population. , 1992, Journal of periodontology.

[22]  Shearer Wt,et al.  Impact of human immunodeficiency virus infection on women and infants. , 1992 .

[23]  R. Genco,et al.  Clinical criteria for the definition of "established periodontitis". , 1992, Journal of periodontology.

[24]  C. Barr,et al.  Oral manifestations of HIV infection. Definitions, diagnostic criteria, and principles of therapy. The U.S.A. Oral AIDS Collaborative Group. , 1992, Oral surgery, oral medicine, and oral pathology.

[25]  J. Gunsolley,et al.  Periodontal status of HIV-seropositive and AIDS patients. , 1991, Journal of periodontology.

[26]  P. Volberding,et al.  Periodontal status of individuals in early stages of human immunodeficiency virus infection. , 1991, Community dentistry and oral epidemiology.

[27]  R. Klein,et al.  Periodontal disease in heterosexuals with acquired immunodeficiency syndrome. , 1991, Journal of periodontology.

[28]  D. Kleinman,et al.  HIV and Periodontal Health , 1991 .

[29]  J. Gunsolley,et al.  Influence of race and periodontal clinical status on neutrophil chemotactic responses. , 1991, Journal of periodontal research.

[30]  E. Lucht,et al.  Periodontal disease in HIV-infected patients in relation to lymphocyte subsets and specific micro-organisms. , 1991, Journal of clinical periodontology.

[31]  R. Fusaro,et al.  The natural history of HIV‐1 infection: staging classifications of disease , 1991, AIDS.

[32]  R. Genco,et al.  Studies of the subgingival microflora in patients with acquired immunodeficiency syndrome. , 1990, Journal of periodontology.

[33]  G. Koch,et al.  Prevalence and risk indicators for periodontal attachment loss in a population of older community-dwelling blacks and whites. , 1990, Journal of periodontology.

[34]  G. Ficarra,et al.  Prevalence of oral lesions among HIV-infected intravenous drug abusers and other risk groups. , 1990, Oral surgery, oral medicine, and oral pathology.

[35]  R. Rozier,et al.  Policy implications of the epidemiology of dental diseases for the prevention and control of periodontal disease: the North Carolina studies. , 1983, Journal of public health dentistry.

[36]  R. Rozier,et al.  The epidemiology of dental diseases in North Carolina. , 1981, Journal of public health dentistry.

[37]  I. Lamster,et al.  The relationship of candidiasis to linear gingival erythema in HIV-infected homosexual men and parenteral drug users. , 1995, Journal of periodontology.

[38]  G. Koch,et al.  Assessment of risk for periodontal disease. II. Risk indicators for alveolar bone loss. , 1995, Journal of periodontology.

[39]  L. Moore,et al.  Periodontal microflora of HIV positive subjects with gingivitis or adult periodontitis. , 1993, Journal of periodontology.

[40]  J. Slots,et al.  Microbiological study of HIV-related periodontitis. , 1991, Journal of periodontology.

[41]  P. Murray,et al.  Periodontal disease. A potential intraoral expression of AIDS may be rapidly progressive periodontitis. , 1987, CDA journal.