Tandarts-specialist in de Parodontologie en Implantologie
Board member Professional Committee of Belgian Society of Periodontics, Belgium
Statement of problem: HIV is a disease which is found worldwide and affects the immune system of the body. Periodontal disease is associated with an altered immune response and bad oral hygiene. Questions arise regarding a possible link between both diseases.
Purpose: Investigating the prevalence of periodontal disease in HIV positive patients compared to HIV negative patients. The possible effect of periodontal treatment on HIV and vice versa.
Material and methods: A literature search on PubMed was done regarding articles published in the last 5 years. Key words used were "HIV, periodontal disease, treatment". Single case studies have been excluded. Literature reviews and cross-sectional studies have been included.
Results: The search resulted in 71 articles, 24 were selected to be read. 17 articles were used. Most articles show a higher prevalence and severity of periodontal disease in HIV- infected patients compared to controls. Especially linear gingival erythema, necrotizing gingivitis and necrotizing periodontitis are more common in HIV-positive patients. Non- surgical treatment of periodontitis showed to have a beneficial impact on clinical and immunological parameters of chronic periodontitis and improvement of HIV-infection status. The introduction of HAART decreased the incidence of oral manifestations of HIV, especially in urban areas. However oral human papilloma virus infections and caries seems to be on the rise in HAART-treated patients.
Conclusions: The findings of this research suggest a higher prevalence in severe periodontal disease. Treatment of this disease is identical in HIV-negative patients; however, a beneficial impact can be found on HIV-infection status. It is suggested that HAART treatment lowers the prevalence of oral manifestations of HIV. The relationship between periodontal inflammation and HIV should be further investigated.