HIV and Periodontal Disease

"Periodontal Considerations in the HIV-Positive Patient" by the Committee on Research, Science and Therapy of The American Academy of Periodontology shows a correlation between a worldwide public health problem known as HIV and periodontal disease. This article reviews clinical signs and symptoms, treatments, and the pathogenesis of HIV-related periodontal findings. HIV predominant mode of transmission is thru heterosexual contact. Many of the problems faced by people infected with HIV result from failure of the immune system to protect from opportunistic infections and cancers. Article goes in detail on several staging systems that were employed in order to understand the relationship of the progression of HIV infection.

It describes a multitude of oral lesions, including unique forms of periodontal disease that have been discovered in individuals infected with HIV. Although the frequency of HIV-associated periodontal diseases appears to be less than previously thought, many researchers agree that an important factor influencing the prevalence of unique periodontal disease in the HIV population is the degree of immunodeficiency.

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The pathogenesis of HIV-associated periodontal diseases remains unclear, but may be the result of microbiota and/or alterations in the host. HIV-gingivitis, now called linear gingival erythema (LGE), and HIV-periodontitis, now called necrotizing ulcerative periodontitis (NUP).

Treatment that is recommended for the LGE and NUP lesions in HIV-positive patients include gross scaling, debridement of necrotic tissue when present and antibiotics. Following initial debridement, follow-up visits are necessary in order to thoroughly remove plaque, calculus, and other deposits and to provide strict control instructions. Also home use of prescribed antimicrobial mouthrinse such as chlorhexidine has been shown to be effective in reducing the acute symptoms of LGE and NUP in HIV-infected patients and in preventing the recurrence of these lesions.(2)

After reading this article it seems that progression of periodontal disease in the presence of HIV infection...