The Impact of Oral Health in HIV Patients on Antiretroviral Therapy

The Impact of Oral Health on Metabolism and Persistent Inflammation in HIV Patients on Antiretroviral Therapy

This is a prospective cohort study designed to investigate the range of metabolic abnormalities observed in patients living with HIV on antiretroviral therapy. This study will also explore the concurrent role of poor oral health in supporting and driving chronic immune activation and inflammation in HIV infection.

This is a prospective cohort study designed to investigate the range of metabolic abnormalities observed in patients living with HIV (PLWH) on antiretroviral therapy (ART). This study will also explore the concurrent role of poor oral health in supporting and driving chronic immune activation and inflammation in HIV infection.

Following enrollment in study, patients will be followed up every 6 months for approximately 2.5 years (30 months). During this period, comprehensive medical records will be obtained, and study data will be updated every 6 months; questionnaires will be handed to patients periodically to assess quality of life and effects of xerostomia on QoL; social history will be assessed using TAPS; oral health will be evaluated every 6 months and blood, saliva, and oral swabs collected every 6 months. DXA scan and panoramic radiographs will also be taken at baseline and 24 months.

At the end of the study, caries rate, periodontal health, bone loss, QoL, salivary quantity and composition, presence or absence of white/red lesions, as well as inflammatory cytokines and immune activation markers will be assessed.

Inclusion Criteria:

• Age ≥18 years
• Has been diagnosed with HIV (as documented by a prior laboratory report of positive HIV-1/2 antibody and/or detectable HIV RNA, available for review by the study team)
• Has received antiretroviral therapy for at least 12 months
• Able and willing to provide informed consent prior to initiation of study procedures
• Willing and able to comply with all study procedures, and likely to be available for the duration of the study

Exclusion Criteria:

• Has been diagnosed with the following xerostomia-related autoimmune conditions: Sjorgen's and sarcoidosis
• Has never received radiation therapy to the head or neck (including radioactive iodine therapy)
• Was taking anti-osteoporotic agents (biphosphonates, denosumab) prior to HIV diagnosis.
• Women who are pregnant at the time of enrollment.