Periodontal health status of HIV infected adults in Kenyatta National Hospital

Abstract

To assess the periodontal health status ofHIV infected adults including the periodontal lesions associated with HIV infection. Design: Descriptive cross-sectional study of HI V patients. Setting: Kenyatta National Hospital. Subjects: HIV positive patients admitted at Kenyatta National Hospital Methods: All HIV infected adults admitted in the medical wards at KNH during the months of Aug and Sept 2005 were examined. Plaque levels were assessed and the periodontal tissues examined for gingival inflammation, probing pocket depths and recession on four sites per tooth. Examination for the presence or absence of linear gingival erythema (LGE), necrotizing ulcerative gingivitis/periodontitis (NUG/P) was included. Results: A total of 109 patients were examined. 40 (36.7%) of them were male and 69 (63.3%) female. 43 (39.4%) of the patients were between 30-39 years. 4 (3.7%) were 17-19 years while 6 (5.5%) were 50-59 years. Only 15 patients (13.8%) were on Anti-Retrovirals. All the patients had plaque however, none had abundant plaque. The mean plaque score was 1.2 and all the individuals were found to have plaque. 95.4% of the patients had early inflammatory changes of the gingival tissues with redness but no bleeding on probing. Bleeding on probing was seen in 40.3% of the patients. Linear gingival erythema was recorded in 17.4% (19) of the patients. Necrotizing ulcerative gingivitis was seen in 6 (5.5%) of the patients while necrotizing ulcerative periodontitis was also seen in 6 (5.5%) individuals. 10 (9.2% ) individuals examined did not have any periodontal breakdown since they did not exhibit any clinical loss of attachment. 21 (19.3%) hadat least one site with 4mm or more loss ofattachment and of these 10 (9.2%) had one site with 5mm or more. 89 (81.7%) had mean loss of attachment of between 0.25-2.5mm. Conclusions: This group of HIV infected individuals did not exhibit extensive periodontal destruction. The presence of periodontal lesions associated with HIV like Liner Gingival Erythema was seen in 17.4%, Necrotizing Ulcerative Gingivitis and Necrotizing Ulcerative Periodontitis were present in 5.5%. Recommendations: The management ofHIV/AlDS patients should include periodontal therapy, oral hygiene instructions and other measures to improve periodontal health. In addition, comparative studies of HIV negative and HIV positive persons are needed so as to define the effects ofHIV on periodontal health.