Anti-infective periodontal therapy promoting improvement in systemic markers of HIV infection

Effects of non-surgical periodontal therapy on clinical and immunological profile and oral colonization of Candida spp in HIV-infected patients with chronic periodontitis

BACKGROUND

After the introduction of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has become a chronic controllable disease. For this reason, chronic conditions related to both HIV infection and senescence, such as chronic periodontitis (CP) need to be studied. This study investigated the impact of non-surgical periodontal therapy (NSPT) on clinical and immunological features of CP, and on oral colonization by Candida spp. in HIV-infected and non-HIV-infected individuals.

METHODS

HIV-infected (test group) and non-HIV-infected (control group) adults patients with CP were selected. Gingival bleeding index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load (only for HIV-infected individuals), salivary cytokines (interleukin, [IL]-6, IL-8, and tumoral necrosis factor-alpha [TNF-α]), and oral Candida infection (colony forming units and species) were assessed at baseline, and 30 and 90 days after NSPT.

RESULTS

Twenty-two HIV-infected patients and 20 non-HIV-infected patients were evaluated. Candida counts and salivary IL-6, IL-8, and TNF-a levels were higher in the test group than in the control group. Both groups showed a decrease in oral Candida counts, GI, PD, IL-6, and IL-8 as well as gain in CAL at 30 and 90 days after NSPT. In addition, patients in the test group showed an increase of CD4+ T lymphocytes and a decrease of viral load.

CONCLUSION

NSPT had a beneficial impact on clinical and immunological parameters of CP, reduction of oral Candida counts, and improvement of HIV-infection status.