Periodontal Disease in Heterosexuals With Acquired Immunodeficiency Syndrome

Abstract

We studied the prevalence and severity of periodontal disease among 181 heterosexual men and women with AIDS. Included were 167 (92%) intravenous drug users (IVDU) and 14 sexual partners of persons at risk for AIDS. Periodontal disease was seen in 71 of 78 (91%) women compared to 75 of 103 (73%) men. Gingivitis was the most severe form of periodontal disease in 7 (9%) women and 15 (15%) men. Increased severity of periodontal disease was seen in women as compared with men (P less than .001); among subjects with periodontitis, 48 (75%) of 64 women had moderate to advanced disease compared to 32 (53%) of 60 men. For individuals with periodontitis, the extent of involvement was associated with severity; 90% of subjects with advanced periodontitis had all 4 quadrants affected. Concurrent oral manifestations of AIDS, including candidiasis, hairy leukoplakia, ulcers and Kaposi's sarcoma were present in 167 (92%) subjects. We conclude that HIV-associated gingivitis and HIV-associated periodontitis are common in heterosexual men and women with AIDS and are often accompanied by other oral manifestations of AIDS. The reason periodontal disease is more severe in women is not known. Clinicians should be aware that these disorders occur in heterosexuals as well as in homosexual men. Further study will be necessary to delineate the pathogenesis of these disorders.

Longitudinal Evaluation of Loss of Attachment in HIV‐Infected Women Compared to HIV‐Uninfected Women

“…The results of this study support findings from previous reports showing no significant differences on the probing depth and attachment loss between HIV‐seropositive and HIV‐seronegative subjects 14,24‐26 and differ from other studies 6,16,17,27 . Two of these publications, one comparing the prevalence of periodontal disease in HIV‐seropositive versus HIV‐seronegative women 16 and the other comparing the prevalence and severity of periodontal disease in HIV‐infected males and females, 17 found that HIV‐infected women have more severe periodontal disease. The effect of antiretroviral therapy on periodontal disease is difficult to interpret and is further complicated by interrelationships between therapy, viral load, and CD4 count.…”

“…In the early 1990s, attention turned to the possible influence of HIV infection on chronic “conventional” periodontal disease 15 . Only one publication addressed periodontal disease progression in HIV‐infected women, 16 despite a report that periodontal disease may be more prevalent in HIV‐infected women than in HIV‐infected men 17 …”

Association of T CD4 Lymphocyte Levels and Chronic Periodontitis in HIV‐Infected Brazilian Patients Undergoing Highly Active Anti‐Retroviral Therapy: Clinical Results

“…The present investigation evaluated the association between immunosuppression, using T CD4 levels as the parameter, and periodontal status in 64 HIV-infected Brazilian patients receiving HAART. 12,15,28,29 Furthermore, the majority of the patients evaluated in the present study showed a moderate periodontal disease, as indicated by low mean PD and CAL. 27 In addition, epidemiological investigations carried out in Brazil observed a prevalence of chronic periodontitis in the general population ranging from 40% to 80%.…”

“…2 Moreover, the increased attachment loss without pocketing, a condition frequently seen in HIV-infected patients, may have resulted from past episodes of ulceration. 2,4,8,[11][12][13][14][15][16] Some cross-sectional investigations have failed to detect any differences in prevalence and severity of periodontal disease in HIV/AIDS individuals compared to healthy controls. 2,4,8,[11][12][13][14][15][16] Some cross-sectional investigations have failed to detect any differences in prevalence and severity of periodontal disease in HIV/AIDS individuals compared to healthy controls.…”

Association of Candida with Linear Gingival Erythema in HIV-Infected Subjects

“…In an early study, Klein et al 1991 reported the higher percentage (85 %) of HIV-associated gingivitis and periodontitis among heterosexual subjects (Klein et al 1991 ). Out of the patients who had HIV-gingivitis as the sole manifestation of periodontal disease, 59 % had involvement of all quadrants.…”