Longitudinal evaluation of loss of attachment in HIV-infected women compared to HIV-uninfected women

Mario Alves, Roseann Mulligan, Douglas Passaro, Susan Gawell, Mahvash Navazesh, Joan Phelan, Deborah Greenspan, John S. Greenspan

Research output: Contribution to journalArticlepeer-review


Background: The Women's Interagency HIV Study (WIHS) is the largest, most detailed, controlled longitudinal collection of data to evaluate the influence of human immunodeficiency virus (HIV) disease and its therapies on the periodontium. Methods: This report evaluates periodontal probing depth (PD), attachment loss (AL), and tooth loss from 584 HIV-seropositive and 151 HIV-seronegative women, recorded at 6-month intervals from 1995 to 2002. Using the random split-mouth method, PD and AL were recorded from four sites per tooth: mesial-buccal, buccal, distal-buccal, and lingual. Influence of viral load, CD4 count, race, smoking, drug use, low income, and level of education were evaluated. Results: At baseline, AL was 1.6 versus 1.1 mm (P=0.003) and PD was marginally deeper (2.1 versus 2.0 mm; P=0.02) in HIV-seropositive versus HIV-seronegative women. Adjusted longitudinal analysis showed that HIV infection did not increase the mean PD (rate ratio [RR], 1.00; 95% confidence interval [CI], 0.96 to 1.04), worst PD (RR, 1.03; 95% CI, 0.98 to 1.09), mean AL (RR, 0.97; 95% CI, 0.96 to 1.02), worst AL (RR, 1.01; 95% CI, 0.94 to 1.07), or tooth loss (RR, 1.02; 95% CI, 1.0 to 1.05). Conclusions: CD4 count and viral load had no consistent effects on PD or AL. Among HIV-infected women, a 10-fold increase in viral load was associated with a marginal increase in tooth loss. The progression of periodontal disease measured by PD and AL did not significantly differ between HIV-infected and HIV-uninfected women. The HIV-seropositive women lost more teeth. Race, smoking, drug use, income, and education level did not influence the results for either group.

Original languageEnglish (US)
Pages (from-to)773-779
Number of pages7
JournalJournal of periodontology
Issue number5
StatePublished - May 2006


  • Attachment loss
  • HIV
  • Periodontal pocket
  • Women

ASJC Scopus subject areas

  • Periodontics


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