Determinants of periodontitis according to the immunological and virological profiles of HIV-infected patients in Yaoundé, Cameroon

• Published in: BMC oral health Vol. 20; no. 1; p. 359
• Main Authors: Fokam, Joseph, Geh, Buolikeze Kuoh Nji, Sosso, Samuel Martin, Takou, Desire, Ngufack, Ezechiel Semengue, Nka, Alex Durand, Bissek, Anne-Cecile Z-K, Eko, David Mindja, Ndjolo, Alexis
• Format: Journal Article
• Language: English
• Published: England BioMed Central 11-12-2020; BMC
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Antiretroviral drugs; Antiretroviral therapy; Cameroon - epidemiology; CD4; CD4 antigen; CD4 Lymphocyte Count; CD8; CD8 antigen; Cytokines; Dentistry; Disease prevention; Flow cytometry; Gingival bleeding index; Gum disease; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Hygiene; Immunology; Infections; Male; Medical laboratories; Medical records; Oral hygiene; Patients; Periodontal diseases; Periodontal Pocket - epidemiology; Periodontitis; Periodontitis - epidemiology; Plaques; Plasma; Quality of Life; Ribonucleic acid; RNA; Statistical analysis; Tumor necrosis factor-TNF; Viral Load; Viremia; Cameroon; CD4; HIV; Periodontitis; Viral load; CD8
• ISSN: 1472-6831; 1472-6831
• DOI: 10.1186/s12903-020-01353-7

HIV infection is associated to different oral manifestations (including periodontal diseases), which have decreased with the advent of antiretroviral therapy (ART). Yet, the occurrence of periodontitis is still consistent among patients with HIV living in sub Saharan-Africa, with limited evidence on the driven factors and mitigating measures in these settings. We aimed at evaluating the occurrence of periodontitis and its associated immunological and virological factors in patients with HIV living in Yaoundé, Cameroon.
We included 165 (44 ART-naïve and 121 ART-experienced) patients > 18 years old attending the Yaoundé Central Hospital and the Chantal BIYA International Reference Centre, from January-April 2018. The periodontal status was assessed by measuring the clinical attachment loss, periodontal pocket depth, plaques index and gingival bleeding index. CD4+/CD8+ cells and viremia were measured using the fluorescence-activated cell sorting method (FACS Calibur) and the Abbott m2000 RT HIV-1 RNA kit respectively. A standard-questionnaire concerning participants' medical records and oral hygiene methods was filled. Data was analyzed and p < 0.05 considered statistically significant.
There was a significantly high prevalence of periodontitis in the ART-naïve (53.2%) compared to the ART-experienced group (37.3%), with a twofold increased risk of the ART-naïve population presenting with periodontitis than the ART-experienced population (OR 2.06, p = 0.03). More importantly, ART-naïve, patients with CD4 < 200 cells presented with higher risk of having periodontitis compared to those with higher CD4-values, with a threefold difference (OR 3.21). Worth noting, males presented with a higher risk of having clinical attachment loss (OR 6.07). There was no significant association between the occurrence of periodontitis and the CD8 (p = 0.45) or viremia (p = 0.10).
In the Cameroonian context, a considerable number of adults infected with HIV suffer from periodontitis regardless of their treatment profile. Nonetheless, ART-naïve patients have a higher risk, indicating the protective role of ART. Interestingly, severely immune-compromised patients and men are vulnerable to periodontitis, thereby highlighting the need for clinicians to refer patients for regular periodontal screening especially male patients and those with low CD4. Such measures could greatly improve the quality of life of the population living with HIV in Cameroon.