Periodontal changes by HIV serostatus in a cohort of homosexual and bisexual men

Abstract

These data represent 20 months of follow-up on 114 homo/bisexual men. Periodontal changes were analyzed in relation to HIV-1 serostatus, immune status, age and plaque. Gingival index (GI), plaque index (PI), and relative attachment levels recorded by the computerized Florida disk probe were performed every 4 months. A threshold of > or = 3.0 mm of relative attachment loss (RAL) was selected as a significant longitudinal change. RAL > or = 3 mm occurred 6.16 times (95% CI = 1.95, 19.40) more frequently among subjects with T4 counts < 200 compared to subjects with counts of 200 or more. Among older subjects (age > or = 35 years), the incidence (33%) of RAL > or = 3 mm was significantly higher (p = 0.004) in more immunosuppressed subjects (T4 < 200) compared to the incidence (5%) in less immunosuppressed subjects (T4 > or = 200); this association was not significant in younger subjects less than 35 years old (p = 0.55). In 78 subjects present at all follow-up visits, averaged GI increased and were significantly higher in the seropositive subjects compared to seronegative subjects, but, GI was not related to T4 cell counts within the seropositive group. Separate linear regression of GI by PI by HIV serostatus revealed a significantly higher slope in the seropositive group compared to the seronegative group (p = 0.04), suggesting greater sensitivity to plaque in the seropositive group.

Conclusion: immunosuppression, especially in combination with older age, may be a risk factor for attachment loss, and HIV seropositivity, independent of T4 cell counts, may be a risk factor for gingival inflammation.