Longitudinal Study of CD4 Counts Variation and Periodontal Variables in HIV-positive Patients

Objectives: To associate variables related with periodontal condition with variations on CD4 lymphocytes values in people living with HIV/aids.
Methods: Initial sample comprised 180 HIV+ patients (21-60 y.o.) under medical supervision. Patients with less than 6 teeth and systemic diseases not related with AIDS were excluded. Medical history was obtained including CD4 count. Periodontal examination was performed at hospital settings and included (8 sites/tooth): probing pocket depth (PD), clinical attachment level (CAL), bleeding index (BI). Patients filled out a questionnaire concerning oral hygiene, dental care and smoking habits, and were referred to a specialized dental clinic in order to get appropriated dental care based on their needs. After returning for medical checkups, accomplishment of the referral was confirmed and medical parameters were recorded. Patients that had started dental treatment were excluded from the study. During a 4 years period, 32 patients remained without dental care after own decision. Statistical analysis included mean, typical error, frequency distribution, Student test and odds ratio.
Results: Patients were divided in: Group 1: patients that had a decrease in CD4 values (n=13; ΔCD4:-174.54+23.19 cel/mm3; ẋ% sites BI=1: 31.65+9.61; ẋ% sites PD>5: 7.38+2.87); and Group 2: patients that had an increase in CD4 values (n=19; ΔCD4:196.21+31.59 cel/mm3; ẋ% sites BI=1: 8.09+1.37; ẋ% sites PD>5: 1.95+1.25). There were no statistical differences between groups in age and time between medical examinations. Significant differences were found between groups in every periodontal parameter (p < 0.05). ROC curve was used in order to dichotomize periodontal variables (%BI=1: 20%). Comparison between groups with %BI=1:>20% and %BI=1:<20%, revealed an OR:3.71 (CI95% 1.97-6.99; p<0.001).
Conclusions: Although participants of this study showed a prevalence of periodontitis comparable to healthy subjects, the results showed higher values of variables related with periodontal disease in subjects that showed a decrease in their immune competence.