HIV, Inflammatory Mediators, and Biofilm Gingival Interface: Pre and Post Periodontal Therapy

Objectives: The objective of this study was to determine the relationship between HIV, immune modulators and periodontal disease severity and to assess how this relationship changes in response to dental therapy.
Methods: A cohort of 163 HIV+ patients were followed longitudinally for 2 years. All patients received comprehensive dental therapy according to their individual needs. Periodontal values were obtained biannually including probing depth, clinical attachment level, and bleeding on probing. Demographic values, smoking status, CD4 counts and HIV viral load were recorded. In a subset of patients, GCF and throat wash samples were collected at baseline and 12 months. Using the AAP and biofilm gingival interface (BGI) classifications, patients were stratified based on disease severity at baseline. Logistic regression was used to determine correlations between viral status, cytokine concentrations and periodontal classification.
Results: Distinct profiles were detected with stratification. AAP stratification placed 80% of individuals in the mild to moderate category while BGI placed 80% of individuals in the diseased/moderate and diseased/ severe categories. Post periodontal treatment SLIPI levels decreased by 25% in the diseased/ moderate group while, Il-6 levels decreased 2 fold in the diseased/moderate group, and CD14 levels decreased by 20%. CD4 counts increased post treatment in gingivitis and diseased/ moderate groups. Plasma viral loads were highest in the diseased/severe group and decreased 2.5 fold post treatment.
Conclusions: Following dental treatment, the concentrations of cytokine markers SCD14, IL-6, SLIPI decreased from baseline to 12 months across the moderate disease groups while CD4 counts increased. Plasma viral loads were associated with severe disease and decreased significantly with treatment.