Doença periodontal e lesões orais na população HIV/aids do centro de referência, controle e tratamento da polícia militar de Minas Gerais

Abstract

The Acquired Immunodeficiency Syndrome (AIDS), a disease caused by HIV (human immunodeficiency virus), is characterized by severe immunosuppression that causes opportunistic infections and neoplasias, many of them in the oral cavity. Periodontal disease (PD) is a bacterial infection that has been associated to the HIV infection which is considered a modifier factor in the disease. There are lines of evidence that sustain the existence of different forms of periodontitis. However, some studies have shown lower prevalence of these entities, especiallyin patients receiving antiretroviral therapy (TARV). The aim of this study was to evaluate the prevalence of PD and oral lesions in patients attended at the Center of Reference, Control and Treatment (CRCT) of the Military Police of Minas Gerais state, describing the clinical and laboratorial parameters of the HIV/AIDS infection as well as factors associated to PD and its severity rate. A prevalence study with internal nested case-control was conducted with a sample of 41 patients (82 controls) paired by age and sex. The oral mucosa and gingiva of allteeth were examined and the following characterstics were evaluated: probing depth, clinical attachment level, bleeding on probing and plaque index. Four criteria were used to define PD. The parameters for the characterization of the HIV/AIDS patients were searched in the service records. The results indicated that the population of the study does not present the predominant socialeconomic profile of the HIV/AIDS infection in Brazil. The majority of the patients had the immunologic system reconstituted by TARV. The oral lesions, present only in the cases, showed lower prevalence than expected for soropositive patients. Cholesterol, triglycerides and positive serology for toxoplasmosis havebeen identified as risk factors for PD associated with HIV. The reduction of LTCD4 (<200cels/mm3) showed a relationship with the deterioration of the PO (p 0,01) according to the AAP/CDC criteria. The prevalence of PO varied, but no difference between cases and controls was observed regardless of the definition criteria.