Dental News - HAART treatment for HIV/Aids patients plays key role in their oral health

Anisha Hall Hoppe, Dental Tribune International

Tue. 30. May 2023

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CHENGDU, China/SENDAI, Japan: Roughly forty million individuals around the world were living with HIV/Aids in 2021. Highly active antiretroviral therapy (HAART) utilises three or more drugs to treat an HIV infection and slow down the progression of Aids. In addition to evaluating demographic data correlation on the oral health of patients with HIV/Aids, a team of researchers in China and Japan evaluated the impact HAART had on the oral microflora and potential for lesion development in the patients.

The researchers noted that oral symptoms are the first symptoms to manifest in 30% of patients, making it a vital diagnostic indicator of the disease. Prior research has shown that HAART treatment mitigates oral diseases in HIV/Aids patients. Through questionnaires, oral examinations and analysis of the microbes present in patients’ oral cavities, the authors evaluated correlations between demographic risk factors and patients’ oral health.

Numerous correlations between demographic factors and oral health were evaluated in the study, and certain conclusions were of particular interest.

Age, sex, education, income and marital status were shown to be related to varying measurements of probing depth (PD) and clinical attachment loss (CAL). Residence and alcohol consumption only affected CAL, whereas body mass index (BMI) showed a correlation with both probing depth and bleeding on probing (BOP)-positive sites. The level of both oral health indicators increased as BMI increased.

Ethnicity had no statistically significant effect on the measured oral health factors. Smoking in the targeted population was statistically associated with PD and CAL at various measurements. Whether or not patients in the target group flossed was also statistically associated with CAL and BOP-positive sites. Not surprisingly, reported dental visit experience was negatively associated with CAL, PD and BOP-positive sites.

When it came to the comparison of oral lesions evaluated in the HIV-infected patients with those in a control group, there was a 47.23% higher incidence of candidiasis caused by Candida albicans, a 7.41% higher incidence of salivary gland disease, a 20.37% higher incidence of oral ulcers and a 19.44% higher incidence of Aids-associated periodontitis. HIV-positive patients displayed a 1.85% lower occurrence of oral hairy leukoplakia and a 3.7% lower occurrence of herpes simplex stomatitis.

Comparing the bioflora collected across three groups—a healthy control group, a group of patients who had undergone HAART treatment for HIV/Aids and a group of patients who had not undergone HAART treatment—the researchers noted that, after evaluating ten phyla, 105 genera and more than 300 species, there were just three genera (Streptococcus, Synergistetes and Veillonella) that were detectable in all three patient groups.

Whereas certain genera were only present in the healthy control group, Fusobacterium, Selenomonas, Campylobacter, Capnocytophaga, Prevotella and Granulicatella were shown to be present in higher numbers of Aids patients treated with HAART compared with those who had not undergone the treatment. More than 200 unique species were found in the group who had not undergone treatment, which the authors believe could represent an association with opportunistic infections. The results indicated that HAART treatment reduces the diversity of microbes present in the oral cavity of Aids patients.

The authors noted that further study is warranted on the mechanism of action by which HAART treatment helps maintain the salivary microecological balance in Aids patients.

The study, titled “Clinical oral condition analysis and the influence of highly active antiretroviral therapy on human salivary microbial community diversity in HIV-infected/AIDS patients”, was published on 29 June 2022 in Frontiers in Cellular and Infection Microbiology.