IADR Abstract Archives
Dental Treatment Modulates Oral Pathogens and Inflammation in Virologically-suppressed HIV+ Participants
Objectives: It was hypothesized that periodontal therapy could modulate oral microbioata and inflammation in the setting of HIV. The objective of this study was to determine the impact of dental treatment on local oral factors in virologically suppressed HIV+ patients on antiretroviral therapy (ART).
Methods: 58 HIV+ subjects on ART from UNC and Meharry were stratified into two groups- in dental care (IC) (n=28) or out of regular dental care (OC) (n=30) at baseline. Patients were provided periodontal therapy/oral hygiene instruction and periodontal status was assessed at baseline 6, and 12 months. Saliva was assessed by qPCR for oral viral (HPV/EBV) or bacterial infections (P.gingivalis[Pg], F.Nucleatum[Fn], S.Sanguinis[Ss], Lactobacillus[Lp]) and by Luminex for cytokines (IL-6,IP-10, sCD163). Statistical Analysis were performed using Graph Pad prism.
Results: The population was 79% male and 86% African American with a mean age of 40, mean CD4 count of 616 cells/ml and mean HIV VL=27 copies/ml. At baseline mean HPV copy number was 2133 in the OC group vs 1901 cp/ml in the IC group. At baseline, gingival Index scores (P=0.012), BOP (P=0.06) and mean extent periodontitis (PD>=4+BOP) were higher in the OC group compared to the IC group. sCD163 and IP-10 levels were higher in the OC group vs IC. Importantly, dental care diminished these differences. Care at 12 mo was associated with decreased Fn (3500-fold, p=0.06) and increased Lp (4000-fold change, p=0.02) likewise mean decrease in fold change of Pg (750-fold) and increase in Ss (4-fold) were detected (ns) (Mann-Whitney) in the OC group. EBV, IL6, sCD163 and IP10 levels also decreased with care.
Conclusions: Inflammation remains a challenge for HIV+ patients on antiretroviral therapy (ART). In the OC group, periodontal therapy diminished pathogens and increased commensals. This was associated with decreased clinical oral inflammation, decreased EBV and decreased oral inflammatory cytokines.
Methods: 58 HIV+ subjects on ART from UNC and Meharry were stratified into two groups- in dental care (IC) (n=28) or out of regular dental care (OC) (n=30) at baseline. Patients were provided periodontal therapy/oral hygiene instruction and periodontal status was assessed at baseline 6, and 12 months. Saliva was assessed by qPCR for oral viral (HPV/EBV) or bacterial infections (P.gingivalis[Pg], F.Nucleatum[Fn], S.Sanguinis[Ss], Lactobacillus[Lp]) and by Luminex for cytokines (IL-6,IP-10, sCD163). Statistical Analysis were performed using Graph Pad prism.
Results: The population was 79% male and 86% African American with a mean age of 40, mean CD4 count of 616 cells/ml and mean HIV VL=27 copies/ml. At baseline mean HPV copy number was 2133 in the OC group vs 1901 cp/ml in the IC group. At baseline, gingival Index scores (P=0.012), BOP (P=0.06) and mean extent periodontitis (PD>=4+BOP) were higher in the OC group compared to the IC group. sCD163 and IP-10 levels were higher in the OC group vs IC. Importantly, dental care diminished these differences. Care at 12 mo was associated with decreased Fn (3500-fold, p=0.06) and increased Lp (4000-fold change, p=0.02) likewise mean decrease in fold change of Pg (750-fold) and increase in Ss (4-fold) were detected (ns) (Mann-Whitney) in the OC group. EBV, IL6, sCD163 and IP10 levels also decreased with care.
Conclusions: Inflammation remains a challenge for HIV+ patients on antiretroviral therapy (ART). In the OC group, periodontal therapy diminished pathogens and increased commensals. This was associated with decreased clinical oral inflammation, decreased EBV and decreased oral inflammatory cytokines.
