Oral Health Status of HIV-Subjects Taking Antiretroviral Therapy in Thailand

1Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand, 2Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand, 3Department of Stomatology, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand, 4Division of Medicine, Hat Yai Regional Hospital, Hat Yai, Thailand, 5Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand

Objectives: To determine oral health status of HIV-subjects taking antiretroviral therapy (ART) compared to those without ART and non-HIV individuals in Thailand.

Methods: History taking and oral examination were performed in HIV-subjects with and without ART and non-HIV individuals. Unstimulated salivary flow rates using a draining method and paraffin-stimulated salivary flow rates were measured. The following data were recorded; type of ART, duration on ART, CD4 cell count, presence of oro-facial pain, presence of oral lesions, presence of cervical caries, feeling of oral dryness, and oral burning sensation.

Results: One hundred HIV-subjects were on ART (Group I, M=53, F=47, age range = 23-57 yr, mean age=37), 57 were not on ART (Group II, M=20, F=37, age range=20-59 yr, mean age= 34), and 50 were non-HIV individuals (Group III, M=25, F=25, age range= 19-59 yr, mean age= 32). Various combinations of ART were prescribed; 94 received nucleotide reverse transcriptase inhibitor (NRTI), 65 received non-nucleotide reverse transcriptase inhibitor (NNRTI), and 14 received protease inhibitor (PI). Duration on ART ranged from 2-120 months (mean 27 months). CD4 count ranged from 9-1,600 cell/mm3 in Group I (mean 383 cell/mm3) and from 5-586 cell/mm3 in Group II (mean 262 cell/mm3). The following variables showed statistically significant difference among the three groups; presence of oro-facial pain (p=0.007), presence of oral lesions (p=0.001), and feeling of oral dryness (p=0.008). Mean unstimulated and stimulated salivary flow rates were significantly different among the three groups (p<0.001). The presence of oral lesions, feeling of oral dryness, and mean unstimulated and stimulated salivary flow rates were also found to be significantly different (p<0.05) when compared between HIV-subjects (Group I and Group II combined) with non-HIV individuals (Group III).

Conclusion: HIV infection and use of ART affect oral health status of HIV-subjects in Thailand.