In the 27 years since the beginning of the HIV/AIDS epidemic in the United States, that which was once an unavoidable death sentence has largely become a chronic condition when properly managed with medication. However, both the manifestation of the virus as AIDS as well as the retroviral therapy used to keep HIV in check can take a heavy toll on a patient, including one's oral health and quality of life.
(Media-Newswire.com) - In the 27 years since the beginning of the HIV/AIDS epidemic in the United States, that which was once an unavoidable death sentence has largely become a chronic condition when properly managed with medication.
However, both the manifestation of the virus as AIDS as well as the retroviral therapy used to keep HIV in check can take a heavy toll on a patient, including one’s oral health and quality of life.
Two recently published USC School of Dentistry studies examine data from the Women’s Interagency HIV Study, a cohort made up of hundreds of HIV-positive and at-risk women at six sites throughout the U.S., to discern how the disease affects American women.
While AIDS itself can increase the chance of mouth lesions, infections and other oral maladies, a common treatment method can have negative oral side effects, according to data collected from the cohort.
Protease inhibitor-based highly active antiretroviral therapy ( HAART ), a treatment used to suppress HIV replication and preserve patient immunity, is a significant risk factor for decreased salivary gland function, explained Mahvash Navazesh, School of Dentistry Diagnostic Sciences Division chair in “Effect of HAART on Salivary Gland Function in the Women’s Interagency HIV Study.” The study was published Nov. 11 in Oral Diseases.
The impact of low salivary flow is much more than just the discomfort of a dry mouth, Navazesh said. With less saliva to wash away cariogenic food and moisten soft tissues, dry mouth can accelerate tooth decay and make irritated tissue more susceptible to infection.
“Saliva plays an important role in maintaining the health of the oral cavity,” she said.
In the study “Oral Health-Related Quality of Life Among HIV-Infected and At-risk Women,” principal investigator and School of Dentistry associate dean of Community Health Programs Roseann Mulligan and her team evaluated not just the oral health of hundreds of cohort participants, but they also examined the psychosocial and emotional impact that the disease’s effects on oral health can have.
“Women participating in this study are minorities, poor, less educated and either HIV-infected or at risk of infection; they are vulnerable women in our society,” said Hazem Seirawan, the study’s second author and research assistant professor at the School of Dentistry.
Participants were evaluated physically and asked questions on several subjects, including functional limitation, discomfort and pain as well as psychological and social discomfort and disability related to their oral health.
On average, HIV-infected women had 10 percent lower oral health-related quality of life compared to non-infected women, Mulligan said. However, after adjusting for significant clinical and behavioral oral health factors, including drug use, the difference in quality of life was much less prominent.
“The study identifies many specific factors where dental professionals can intervene and help both HIV-positive and at-risk patients have better oral health-related quality of life,” Mulligan said.
Simply having access to more follow-up care can help greatly, Seirawan added.
“It seems that follow-up visits, when women came for their semiannual check-up, were significant in reducing the difference in oral health-related quality of life between the two groups of women,” he said.
The study appeared Sept. 8 in Community Dentistry and Oral Epidemiology.
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