Which periodontal changes are associated with HIV infection?

To assess the validity of diagnostic criteria for HIV-associated periodontal diseases, existing sets of criteria were applied post-hoc to cross-sectional data of the periodontal health of men with and without HIV and their ability to predict HIV infection was compared. Criteria for gingival or periodontal ulceration predicted HIV infection to a similar level. Criteria sensitive to erythema of the attached gingiva and interdental craters had high positive predictive values. Distinct gingival red bands did not predict HIV. 3 HIV-associated periodontal changes were recognised: erythema of the attached gingiva; necrotising periodontal disease and interdental craters. Epidemiological research should also consider conventional gingivitis and lost periodontal attachment. The presence or absence of all 5 conditions should be recorded at each site. Hierarchies of diagnoses with only the most severe condition assigned to each individual swamp valuable information.