Anaerobe group, Department of Medical Biosciences, University of the Western Cape, Western Cape, South Africa.
BMC Oral Health. 2013 Dec 3;13:69. doi: 10.1186/1472-6831-13-69.
The immunosuppresion in HIV patients makes them highly susceptible to microbial infections. The aim of the study was to establish whether HIV stage (as depicted by CD4+ T lymphocyte counts) could independently be associated with periodontal status (as revealed by the measurement of clinical indices).
One hundred and twenty HIV-infected patients attending an infectious diseases clinic in the Western Cape, South Africa were included in the study. The periodontal clinical indices such as plaque index, gingival index, pocket probing depth and clinical attachment levels were measured on the mesial aspect of the six Ramfjord teeth. The CD4 + T cell counts were taken from the patients' medical records and patients' HIV stage determined and grouped according to their CD4+ T cell counts into A (<200 cells /mm3), B (200-500 cells /mm3) and C (>500 cells /mm3).
The mean age of 120 HIV-positive patients was 33.25 years and the mean CD4 + T cell count was 293.43 cells/mm3. The probing depth and clinical attachment loss were found to be significantly associated with the total CD4 + T cell counts but not with HIV stage. Significant correlations were found between age and all clinical indices except for clinical attachment loss. No correlation was found between age and HIV stage of the patients. The use of antiretroviral therapy was significantly associated with probing depth and clinical attachment loss, but not with plaque nor gingival index. Significant associations were observed between smoking and all of the clinical indices except for the gingival index. A significant association was observed between the use of interdental aids and all the clinical indices except for probing depth, while brushing was significantly associated with plaque index only. CD4 + T cell counts were significantly associated with brushing frequency (p = 0.0190) and the use of interdental aids (p = 0.0170).
The findings of this study conclude that HIV stage, ART and age are not independent risk factors for changes in the periodontal status of HIV-positive subjects but rather that smoking and oral hygiene habits determine their susceptibility to disease.
HIV 患者的免疫抑制使他们极易受到微生物感染。本研究旨在确定 HIV 分期（通过 CD4+T 淋巴细胞计数来描述）是否可独立与牙周状况相关（通过测量临床指标来揭示）。
本研究纳入了 120 名在南非西开普敦传染病诊所就诊的 HIV 感染者。在 Ramfjord 牙齿的近中面测量了牙周临床指标，如菌斑指数、牙龈指数、牙周袋探诊深度和临床附着水平。从患者病历中获取 CD4+T 细胞计数，并根据 CD4+T 细胞计数确定患者的 HIV 分期并分组，分为 A（<200 个细胞/mm3）、B（200-500 个细胞/mm3）和 C（>500 个细胞/mm3）。
120 名 HIV 阳性患者的平均年龄为 33.25 岁，平均 CD4+T 细胞计数为 293.43 个细胞/mm3。牙周袋探诊深度和临床附着丧失与总 CD4+T 细胞计数显著相关，但与 HIV 分期无关。除临床附着丧失外，年龄与所有临床指标均呈显著相关性。年龄与患者的 HIV 分期无相关性。抗逆转录病毒治疗的使用与牙周袋探诊深度和临床附着丧失显著相关，但与菌斑指数和牙龈指数无关。吸烟与所有临床指标均呈显著相关性，除了牙龈指数。使用牙间清洁工具与所有临床指标均呈显著相关性，除了牙周袋探诊深度，而刷牙仅与菌斑指数显著相关。CD4+T 细胞计数与刷牙频率（p=0.0190）和使用牙间清洁工具（p=0.0170）显著相关。
本研究的结果表明，HIV 分期、ART 和年龄不是 HIV 阳性患者牙周状况变化的独立危险因素，而是吸烟和口腔卫生习惯决定了他们对疾病的易感性。
