Salivary Biochemical Parameters in People Living With HIV on ART and Dental Caries: a Cross-Sectional Study in Monastir, Tunisia

Objectives: The aim of the study was to investigate salivary biochemical parameters and dental caries (DC) in adult PLWHA on antiretroviral therapy (ART) and compare the findings with people negative for HIV infection.
Methods: Fifty HIV positive individuals were enrolled as a test group (TG) and 50 HIV negative individuals as a control group (CG). Assessment of DC (DMFT) was performed using WHO guidelines. Digital panoramic radiographs were taken to detect hidden caries. Non-stimulated saliva was collected between 9 and 12 a. m for 5 minutes to evaluate 18 biochemical parameters and salivary flow rate (SFR). According to data distribution, parametric or non parametric tests were used. The level of significance was set at p< 0.05%.
Results: Patients’ mean ages and M/F sex ratios for TG and CG were 38.80±9.69 y.o. vs. 37.98±13.47 y.o. and 3.54 vs. 2.33, respectively. Higher means of decayed teeth were recorded in TG, 4.47±3.00 vs. 3.88±2.81 in CG with no significant difference (p=0.41) and significantly lower means of filled teeth 2.38±2.16 vs. 4.16±3.35 (p=0.01) were noted, respectively. Therefore, no statistical significant difference was noted in DMFT indices between the 2 groups (8.04±6.90 vs. 8.52±6.24, p=0.71). The following salivary parameters were significantly lower in TG compared to CG, respectively: mean SFR 0.44±0.18 ml/min vs. 0.61±0.26 ml/min; median levels of sodium and chlorides, 4 mmol/L and 13.5 mmol/L vs. 9 mmol/L and 19 mmol/L (p<0.001) and uric acid, 103.50 mmol/L vs. 163 (p=0.009). However, higher median levels were recorded with calcium, 1.09 mmol/L vs. 0.54 (p<0.001) and sIgA 23 mg/dl vs. 5 mg/dl (p<0.001). A positive correlation was found in TG between DC and urea, potassium, and chlorides (p<0.05).
Conclusions: Preventive measures should be implemented by policy decision makers to improve the access to oral care services for PLWHA. Indeed, Saliva could be a useful tool to evaluate PLWHA health status on ART.