Revista de Odontologia da UNESP
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Revista de Odontologia da UNESP
Original Article

Subjects harboring HIV show poor clinical periodontal condition and higher prevalence of Porphyromonas gingivalis and  Tannerella forsythia

Portadores do HIV apresentam pior condição clínica periodontal e maior prevalência de Porphyromonas gingivalis e Tannerella forsythia

Guimarães, Gustavo; Guimarães, G. C. N.; Cortelli, José Roberto; Cogo, Karina; Costa, Fernando Oliveira; Aquino, Davi Romeiro; Lustosa, Alexandre; Cortelli, Sheila Cavalca

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Abstract

Objective: This cross-sectional study aimed at understanding whether clinical features and frequency of the periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola differ in periodontitis subjects infected with HIV when compared to non-infected subjects. Material and method: 35 periodontitis subjects were selected for the HIV+ group and 35 for the HIV-group; both groups were matched according to age, gender and a site-based criterion to determine periodontal disease.  In a second visit, clinical periodontal status of the whole mouth of each participant was determined by plaque index (PI), gingival index (GI) bleeding on probing index (BOP), probing depth (PD) and clinical attachment level (CAL) measurements. The frequency of P. gingivalis, A. actinomycetemcomitans, T. forsythia and T. denticola was assessed by polymerase chain reaction (PCR) from unstimulated saliva samples. Statistical analysis was performed using the Mann Whitney, Student-t and Chi-Square tests (p<0,05). Result: Despite screening through a specific selection criterion, HIV+ subjects showed more periodontal breakdown, demonstrated by higher mean values of PD, CAL (p<0.05, Student-t test), PI, GI, BOP (p < 0, 05, Mann Whitney test) in comparison to HIV- controls. Also, a higher number of HIV+ subjects harbored two of the searched species: P. gingivalis (p = 0.0007, chisquare) and T. forsythia (p = 0.0001, Chi-square). Conclusion: HIV+ patients had poorer periodontal status and a higher prevalence of P. gingivalis and T. forsythia, two red complex bacterial species, which are clearly associated with damaged periodontal tissues.

Keywords

Acquired immunodeficiency syndrome, microbiology, bacteria, periodontitis.

Resumo

Objetivo: O presente estudo transversal objetivou entender se os aspectos clínicos periodontais e a frequência dos patógenos periodontais Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia diferem em pacientes periodontais infectados pelo HIV comparativamente a indivíduos não infectados pelo vírus. Material e método: Foram selecionados para o estudo indivíduos com periodontite sendo 35 HIV+ e 35 HIV-; ambos os grupos foram pareados quanto a idade, gênero e um critério sítio-dependente de determinação de doença periodontal. Em visita subsequente, o exame periodontal completo determinou a condição periodontal geral dos indivíduos pelas mensurações do índice de placa (IP), índice gengival (IG), índice de sangramento à sondagem (ISS), profundidade de sondagem (PS) e nível de inserção clínica (NIC). A frequência das espécies bacterianas foi avaliada por meio de reação de polimerase em cadeia (PCR) — a partir de amostras obtidas da saliva não estimulada. A análise estatística foi realizada por meio dos testes Mann-Whitney, t de Student e Qui-quadrado (p<0,05). Resultado: Apesar da triagem através de critério especifico de seleção, indivíduos HIV+ apresentaram maior destruição periodontal revelada pelas maiores médias de PS, NIC (p<0,05, t de Student), IP, IG, ISS (p<0,05, Mann Whitney). Além disso, um maior número de indivíduos HIV+ alocaram duas das espécies pesquisadas: P. gingivalis (p= 0,0007, Qui-Quadrado) e T. forsythia (p= 0,0001, Qui-Quadrado). Conclusão: Indivíduos HIV+ apresentaram pior condição periodontal e frequência mais elevada de P. gingivalis e T. forsythia, espécies do complexo vermelho que estão claramente associadas a tecidos periodontais danificados. 

Palavras-chave

Síndrome de Imunodeficiência Adquirida, microbiologia, bactérias, periodontite.

References



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