Molecular Detection of Periodontopathic Microorganisms in HIV Patients

Objectives: To compare the detection frequency of periodontal pathogens using molecular methods, in people living with HIV with and without highly active antiretroviral therapy (HAART).
Methods: The study sample comprised 46 patients divided into two groups: A: HIV+ without HAART (n: 13) (aged 16-48 years), B: HIV+ under HAART (n: 33) (aged 20-58 years). Patients with less than 6 teeth, systemic conditions unrelated to AIDS, and/or receiving dental or antibiotic treatment prior to oral examination were excluded. Patient HIV viral loads (VL) and CD4⁺counts were obtained from clinical records.Periodontal examination (bleeding on probing-BOP, probing depth-PD and clinical attachment level-CAL) was performed by calibrated dentists. Subgingival biofilm samples (n=184) were collected by placing sterile paper points into each pocket. The samples were transported in 1ml of RTF medium. Molecular detection of periodontopathic bacteria was performed by end-point PCR using specific primers (Ashimoto et al., 1996). Amplicons were separated by electrophoresis in 2% agarose gel with TAE buffer and GelRed®. Statistical analysis was performed using Student’s t test and Pearson's chi-squared test.
Results: No significant differences in BOP, PD or CAL were observed between groups (BOP p: 0.622; PD p: 0.185; CAL p: 0.066). Group A showed significantly higher VL (p〈0.001). However, no significant differences in CD4+ counts were observed (p: 0.099). P. gingivalis, T. forsythia and F. nucleatum were detected similarly in both groups. A. actinomycetemcomitans (Aa) was detected more frequently in group A (p〈0.001/ODDS A/B: 16.031 CI 5.56-46.17). T. denticola was the marker in group B (p: 0.001/ODDS B/A: 6.58 CI 1.93-22.22).
Conclusions: The absence of treatment and detectable viral loads would increase Aa detection frequency, which could aggravate patient’s periodontal status due to virulence factors of this microorganism.