Effect of Non-Surgical Periodontal Therapy on Clinical Parameters of Periodontitis, Oral Candida spp. Count and Lactoferrin and Histatin Expression in Saliva and Gingival Crevicular Fluid of HIV-Infected Patients.

BACKGROUND: Periodontitis (PDT) has gained attention in the literature with the increase in life expectancy of people living with HIV on combined antiretroviral therapy (cART). Thus, the search for inflammatory biomarkers could be useful to understand the pathophysiology of chronic oral diseases in the cART era. OBJECTIVE: The aim of this study was to evaluate the impact of non-surgical periodontal therapy (NSPT) on clinical parameters of PDT, Candida spp. count and expression of lactoferrin (LF) and histatin (HST) in saliva and gingival crevicular fluid (GCF) of HIV-infected patients. METHODS: Bleeding index (BI), probing depth (PD), clinical attachment level (CAL), colonyforming units (CFUs) of Candida spp, and LF and HST levels were measured in saliva and GCF of both groups at three different times: baseline (before treatment), and 30 and 90 days after the NSPT. Clinical, mycological and immunoenzymatic analyses were also performed. RESULTS: Twenty-two HIV-infected patients and 25 non-HIV-infected patients with PDT participated in the study. NSPT was effective in improving periodontal clinical parameters, including ≤ 4 sites with PD ≤ 5mm and BI ≤ 10%. Significant change in oral Candida spp. count occurred neither between the two groups nor after NSPT. And the salivary and GCF levels of LF and HST were not influenced by the NSPT; by contrast, except for salivary LF, HST and LF were shown to exhibit significantly higher levels in HIV-infected than in non-HIV-infected patients. CONCLUSION: NSPT was effective in improving periodontal disease parameters in HIV-infected patients, but did not affect LF and HST expression in saliva and GCF of HIV-infected patients.

Non-surgical periodontal debridement affects subgingival bacterial diversity in patients with HIV-1 and periodontitis.

BACKGROUND: Following human immunodeficiency virus-1 (HIV-1) infection and antiretroviral therapy, the development of periodontal disease was shown to be favored. However, the influence of HIV-1 infection on the periodontal microbiota after non-surgical periodontal debridement (NSPD) needs a broad comprehension. This work aimed to compare the subgingival microbiological content of patients infected with HIV-1 and controls (non-infected) with periodontitis undergoing NSPD. METHODS: The bacterial profile of subgingival biofilm samples of patients with HIV-1 (n = 18) and controls (n = 14) with periodontitis was assessed using 16S rRNA gene sequencing. The samples were collected at baseline, 30, and 90 days after NSPD. The taxonomic analysis of gingival microbiota was performed using a ribosomal RNA database. The microbiota content was evaluated in the light of CD4 cell count and viral load. RESULTS: Both HIV and control groups showed similar stages and grades of periodontitis. At baseline, the HIV group showed higher alpha diversity for both healthy and periodontal sites. Streptococcus, Fusobacterium, Veillonella and Prevotella were the predominant bacterial genera. A low abundance of periodontopathogenic bacteria was observed, and the NSPD induced shifts in the subgingival biofilm of patients with HIV-1, leading to a microbiota similar to that of controls. CONCLUSIONS: Different subgingival microbiota profiles were identified-a less diverse microbiota was found in patients infected with HIV-1, in contrast to a more diverse microbiota in controls. NSPD caused changes in the microbiota of both groups, with a greater impact on the HIV group, leading to a decrease in alpha diversity, and produced a positive impact on the serological immune markers in patients infected with HIV-1. Control of periodontitis should be included as part of an oral primary care, providing the oral health benefits and better control of HIV-1 infection.

Effects of non-surgical periodontal therapy on clinical and immunological profile and oral colonization of Candida spp in HIV-infected patients with chronic periodontitis.

BACKGROUND: After the introduction of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection has become a chronic controllable disease. For this reason, chronic conditions related to both HIV infection and senescence, such as chronic periodontitis (CP) need to be studied. This study investigated the impact of non-surgical periodontal therapy (NSPT) on clinical and immunological features of CP, and on oral colonization by Candida spp. in HIV-infected and non-HIV-infected individuals. METHODS: HIV-infected (test group) and non-HIV-infected (control group) adults patients with CP were selected. Gingival bleeding index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load (only for HIV-infected individuals), salivary cytokines (interleukin, [IL]-6, IL-8, and tumoral necrosis factor-alpha [TNF-α]), and oral Candida infection (colony forming units and species) were assessed at baseline, and 30 and 90 days after NSPT. RESULTS: Twenty-two HIV-infected patients and 20 non-HIV-infected patients were evaluated. Candida counts and salivary IL-6, IL-8, and TNF-a levels were higher in the test group than in the control group. Both groups showed a decrease in oral Candida counts, GI, PD, IL-6, and IL-8 as well as gain in CAL at 30 and 90 days after NSPT. In addition, patients in the test group showed an increase of CD4+ T lymphocytes and a decrease of viral load. CONCLUSION: NSPT had a beneficial impact on clinical and immunological parameters of CP, reduction of oral Candida counts, and improvement of HIV-infection status.