The effect of antiretroviral therapyon the periodontal conditions of patients with HIV infection: A systematic review and meta-analysis.

Abstract

To assess any differences (1) in the prevalence of periodontitis and necrotizing periodontal diseases, specifically necrotizing gingivitis (NG) and necrotizing periodontitis (NP) between HIV patients receiving antiretroviral therapy (HAART) and those not receiving the therapy and (2) in the severity of periodontitis based on probing depths (PDs) and clinical attachment loss (CAL) between the two groups. Systematic electronic search on five databases (PubMed, Google Scholar, Scopus, Web of Science and Scielo) was conducted to identify cross-sectional and longitudinal studies reporting on prevalence of NG, NP and periodontitis among HIV patients who either receive or do not receive HAART treatment. The differences in clinical parameters of PDs and CAL among these patients were assessed. Eighteen articles were considered. The meta-analysis for NG showed that the overall assessment for the relative frequency ratio in the two groups was 0.45 (n=7; 95% confidence interval [CI]: [0.21, 0.97]; p < .042). Regarding NP, the overall assessment for the relative frequency ratio in both groups was 0.60 (n=5; 95% CI [0.22, 1.64]; p=.321). With regard to periodontitis, the overall assessment for the relative frequency ratio in the two groups was 1.17 (n=9; 95% CI [0.90, 1.52]; p=.248). No significant differences in PD and CAL were found between the two groups 0.00 (n=3; 95% CI [-0.52, -0.53]; p=.985) and 0.32 (n=3; 95% CI [-0.19, 0.82]; p=.22), respectively. The prevalence of NG appeared to be significantly reduced in patients receiving antiretroviral therapy. No statistical significant difference was found in the prevalence of NP or periodontitis between the two groups.