Relationship between CD4+ T-cell counts at baseline and initial periodontal treatment efficacy in patients undergoing treatment for HIV infection: A retrospective observational study

AIM

To retrospectively investigate the relationship between the CD4+ T-cell counts at baseline and the efficacy of the initial periodontal treatment of patients undergoing treatment for human immunodeficiency virus (HIV) infection using the periodontal inflamed surface area (PISA).

MATERIALS AND METHODS

Thirty-three patients with chronic periodontitis who had undergone periodontal examination at baseline and after the initial periodontal treatment were enrolled. PISA was calculated from the periodontal probing depth and bleeding on probing, and the ratio of PISA after treatment to that at baseline (PISA response ratio) was calculated. Groups with a response ratio of <1 and ≥1 were defined as the improvement and the non-improvement groups, respectively.

RESULTS

PISA after the initial periodontal treatment significantly decreased compared with that at baseline (p < .05). A weak negative correlation was found between the PISA response ratio and CD4+ T-cell counts at baseline (p < .05). The CD4+ T-cell counts at baseline were significantly higher in the improvement group than in the non-improvement group (p < .05). Multivariate analysis revealed that the CD4+ T-cell counts at baseline was an independent factor that affects the PISA (p < .05).

CONCLUSIONS

The higher the CD4+ T-cell counts at baseline in patients undergoing treatment for HIV infection, the more effective the initial periodontal treatment.

Enteric pathogens in HIV-positive patients with diarrhoea and their correlation with CD4+ T-lymphocyte counts

BACKGROUND AND OBJECTIVES

Opportunistic parasitic infections are among the most serious infections in human immunodeficiency virus (HIV) positive patients and claim number of lives every year. The present study was conducted to determine the prevalence of intestinal parasites and to elucidate the association between intestinal opportunistic parasitic infection and CD4 (CD4+ T lymphocyte) counts in HIV-positive patients.

MATERIALS AND METHODS

The study was done on 266 HIV-positive patients presenting with diarrhoea and 100 HIV-positive patients without diarrhoea attending the integrated counselling and testing centre (ICTC) of SMS hospital, Jaipur. Simultaneously, CD4+ T-cell count estimation was done to assess the status of HIV infection vis-à-vis parasitic infections. The identification of pathogens was done on the basis of direct microscopy and different staining techniques.

RESULTS

Out of 266 patients with diarrhoea, parasites were isolated from 162 (i.e. 60.9%) patients compared to 16 (16%) patients without diarrhoea. Cryptosporidium parvum (25.2%) was the predominant parasite isolated in HIV-positive patients with diarrhoea followed by Isospora belli (10.9%). Parasites were more commonly isolated from stool samples of chronic diarrhoea patients, (77% i.e. 128/166) as compared to acute diarrhoea patients (34% i.e. 34/100) (P<0.05). The maximum parasitic isolation was in the patients with CD4+ T cell counts below 200 cells/μl.

CONCLUSIONS

Chronic diarrhoea in HIV-positive patients with CD4+ T-cell counts <200/μl has high probability of association with intestinal parasitic infections. Identification of these parasitic infections may play an important role in administration of appropriate therapy and reduction of mortality and morbidity in these patients.

Epidemiological and Immunological Characteristics at the Time of HIV Diagnosis for HIV/AIDS Cohort Registrants Representative of HIV-Infected Populations in Korea

OBJECTIVES

The Korea HIV/AIDS cohort was constructed with 18 hospitals that care for HIV-infected individuals in 2006. We compared the epidemiological and immunological characteristics of the cohort registrants with those of the HIVinfected population at the time of HIV diagnosis.

METHODS

This study was conducted on 5717 people living with HIV/AIDS from 1985 to 2009, of which 789 individuals registered with the Korea HIV/AIDS cohort study. Individuals who had data from initial CD4+ T-cell counts measured within 6 months following HIV diagnosis were selected as study participants to predict the status of disease progression at the time of HIV diagnosis. A total of 2886 patients (50%) were selected from people living with HIV/AIDS, of whom 424 individuals (54%) were cohort registrants. The χ(2) test and Wilcoxon rank sum test were used for analysis.

RESULTS

The distributions of age, marital status, diagnosed regions, reason for HIV testing, and screening site were similar between the HIV-infected population and the cohort registrants. In 1985-2004, the male ratio for the cohort registrants (94.3%) was significantly higher than that measured for the HIV-infected population (89.5%) (p = 0.0339). With regard to transmission route, homosexual contact of cohort registrants (46.6%) was higher than that of the HIV-infected population (40.1%) (p = 0.022) in 2005-2009. No statistical difference in CD4+ T-cell counts at the time of HIV diagnosis was found between the HIVinfected population and cohort registrants (p = 0.2195).

CONCLUSION

The Korea HIV/AIDS cohort registrants represent the HIV-infected population, and the data collected from this cohort could be used as a foundation for national statistics.