Necrotizing Ulcerative Periodontitis: A Marker for Immune Deterioration and a Predictor for the Diagnosis of AIDS

Abstract

A multitude of oral lesions have been described in individuals infected with the human immunodeficiency virus (HIV). Few studies have attempted to correlate specific oral findings with immune status and HIV disease progression in the population reflecting the demographic profile of this epidemic. A prospective study was conducted among 700 ambulatory HIV-infected individuals seeking dental care between July 1, 1988 and June 30, 1992. Patients entered the study when they first applied for care and were followed at regular intervals unless death occurred before the conclusion of the study. The prevalence rate of necrotizing ulcerative periodontitis (NUP) was calculated for the entire population and specific to race, gender, and HIV transmission category. Survival analysis was used to estimate the cumulative probability of death within 24 months of a NUP diagnosis. The association between NUP diagnosis and CD4+ cell count below 200 cells/mm3 was also investigated, and it was found that HIV-infected individuals presenting with a diagnosis of NUP were 20.8 times as likely to have a CD4+ cell count below 200 cells/mm3 compared to HIV-infected individuals presenting without NUP. The prevalence of NUP was 6.3%. The lesion was significantly more common among men having sex with men (MSM), 8.4%, compared with non-MSM males, 1.8%. No racial difference was noted. The mean CD4+ cell count for patients with NUP was 51.8 cells/mm3 (SD +/- 71.2) while the median CD4+ cell count was 32.0 cells/mm3. The predictive value of a CD4+ cell count below 200 cells/mm3 in patients with this lesion was 95.1%. A cumulative probability of death within 24 months of a NUP diagnosis was 72.9%.(ABSTRACT TRUNCATED AT 250 WORDS)

Lesiones orales asociadas con la infección por VIH/sida en individuos sin tratamiento antirretroviral en el Hospital San Juan de Dios de Bogotá

“…bastante por encima, ya que los investigadores informan cifras cercanas al 40%, explicables por la facilidad de acceso a los servicios de salud en dichos países. En cuanto al tipo de enfermedad más prevalente, la candidosis oral, se confirma lo encontrado por De igual manera, las gingivitis-periodontitis asociadas con el VIH y la leucoplasia vellosa se comportan de manera parecida, lo cual seiiala su importancia como trazadoras de infección VIH y como predictoras de desarrollo de sida (15,16,28,(47)(48)(49)(50)(51). Sería interesante que en los estudios futuros se contara con la confirmación histológica de las lesiones leucoplásicas, tal como lo recomiendan ciertos autores (10, [36][37][38][39][40], ya que algunas de ellas pudieran corresponder a candidosis hiperplásica, liquen plano o lesiones penfigoides, semejanzas que sesgarian los resultados (52,53).…”

Research Progress on the Relationship Between Oral Microbial Community and Tumor

“…A subsequent study [46] proved that chronic periodontitis is a risk factor for HIV patient suffering from cancer. Immunological studies showed significantly decreased T cells in gingival tissues of HIV-positive patients [47] . Modifications were also noted in local immune responses, such as increased inf lammatory mediators and polymorphonuclear leukocyte accumulation.…”

HIV/AIDS and Oral Health in Socially Disadvantaged Communities

“…It can take two forms: the rapid and severe condition called necrotizing ulcerative periodontitis (NUP), (Glick et al, 1994) and its associated and possibly precursor condition called linear gingival erythema (LGE), (Grbic et al, 1995). The presenting clinical features of these diseases often differ from those in non-HIV-infected persons in that unlike for non-HIV-related periodontal disease LGE and NUP often occur in clean mouths where there is very little plaque or calculus to account for the gingivitis.…”