       Document 0340
 DOCN  M9610340
 TI    Loss of periodontal attachment in HIV-seropositive military personnel.
 DT    9601
 AU    Tomar SL; Swango PA; Kleinman DV; Burt BA; Centers for Disease Control
       and Prevention, Atlanta, GA, USA.
 SO    J Periodontol. 1995 Jun;66(6):421-8. Unique Identifier : AIDSLINE
       MED/96023910
 AB    The cross-sectional relationship between severe loss of periodontal
       attachment (LPA) and worsening immune status due to HIV infection was
       evaluated in 474 HIV-infected subjects (416 men, 58 women) aged 18 to 49
       years who had been classified at stages 1 through 6 of the Walter Reed
       Army Institute of Research (WR) Staging Classification System. LPA was
       measured at four sites per tooth using a manual probe; severe LPA was
       defined as > or = 1 site/subject exhibiting > or = 5 mm LPA. Severe LPA
       was found in 94 (20%) of the subjects. Modeling with multiple logistic
       regression analysis revealed that WR stage and peripheral CD4+
       lymphocyte cell counts were not significant independent predictors of
       severe LPA. Severe LPA was more common in subjects at WR stage 5 or 6
       who exhibited oral candidiasis (OC), a marker of immune system damage,
       than in persons at those WR stages without OC (odds ratio = 7.85; 95%
       confidence interval (CI) = 1.94-31.81). After the analysis controlled
       for WR stage, younger subjects receiving AZT had greater odds of severe
       LPA than same-age subjects not taking the drug (e.g., odds ratio for
       subjects aged 30 years = 2.59; 95% CI = 1.22, 5.49). Other significant
       predictors in the model included male sex; retired military status;
       cigarette smoking; and presence of cratered, ulcerated, or necrotic
       interdental papillae. HIV-associated immune deficiency may be associated
       with localized severe LPA, but this may be an indirect association due
       to medication use, opportunistic infection, or other factors not
       captured by the WR staging system or peripheral CD4+ cell
       counts.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Adolescence  Adult  Age Factors  Antiviral Agents/THERAPEUTIC USE
       AIDS-Related Opportunistic Infections/COMPLICATIONS  Candidiasis,
       Oral/COMPLICATIONS  Cross-Sectional Studies  CD4 Lymphocyte Count
       Female  Forecasting  Gingival Diseases/COMPLICATIONS  Human  HIV
       Infections/CLASSIFICATION/COMPLICATIONS/DRUG THERAPY  HIV
       Seropositivity/CLASSIFICATION/*COMPLICATIONS/DRUG THERAPY  Logistic
       Models  Male  Middle Age  *Military Personnel  Odds Ratio  Periodontal
       Attachment Loss/CLASSIFICATION/*COMPLICATIONS  Sex Factors
       Smoking/ADVERSE EFFECTS  Support, U.S. Gov't, P.H.S.
       Zidovudine/THERAPEUTIC USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

