Comparative Evaluation of Periodontal Disease Progression With and Without Highly Active Antiretroviral Therapy (HAART) in HIV-positive Patients

Aim: Periodontal disease is an inflammatory disease which results is host-microbial interactions and tissue destruction as a result of microbial actions and exaggerated host immune response. Human immunodeficiency virus (HIV) causes a viral disease which leads to immunocompromised state and can cause periodontal disease initiation and unusual progression of disease course. Prevalence of oral lesions and acute periodontal lesions associated with HIV has significantly reduced with highly active antiretroviral therapy (HAART). The purpose of this study was to compare the periodontal disease progression with and without HAART in HIV-positive patients. Materials and Methods: This was a cross-sectional study, and 225 HIV-positive patients were selected by purposive sampling method. These patients were divided into three groups of 75 each: Group 1-without HAART, Group 2-HAART < 5 years, and Group 3-HAART >= years. Patient's periodontal status was evaluated at baseline, 4, 8, and 12 months. Parameters such as plaque index (PI), gingival index (GI), probing pocket depth, clinical attachment level (CAL), and number of teeth lost during the period of study were assessed at each visit. Significance of differences in periodontal parameters over a period of 12 months in all three groups was determined using repeated-measures analysis of variance (ANOVA). Intergroup comparison at baseline and 4, 8, and 12 months was done by one-way ANOVA. Intragroup comparison over the duration was done by repeated-measures ANOVA. Pearson's correlation for GI and PI was performed. Results: The result of the present study showed that plaque and gingival scores reduced significantly in both Groups 2 and 3 (P < 0.05), whereas the scores (PPD) and CAL showed no statistical difference at any of the time intervals and over the duration of 1 year in intra- and inter-group comparisons (P > 0.05). There was tooth loss in all the three groups from baseline to 12 months. Conclusion: HAART had no consistent effect on periodontal status and tooth loss; however, patients on HAART showed improvement in their plaque and gingival health status.