Correlation of Dental and Periodontal Status With HIV Presence and Initial CD4 Counts: An Albanian Prospective Observational Study

Background Different pathologies are encountered more often in human immunodeficiency virus (HIV)-infected patients, such as bacterial, fungal, viral infection, and neoplastic diseases. Recently, studies have shown that HIV-infected individuals have poorer oral health outcomes, worse dentition, and aggressive forms of periodontitis. This study aims to investigate the dental and periodontal status of HIV-infected patients, the correlation between CD4+ level and the CD4 percentage with dentition, and periodontal status. Methodology A prospective observational study was conducted in the University Dental Clinic and the Infective Service of University Hospital Center "Mother Teresa" in Tirana, Albania. All patients newly diagnosed with HIV infection (35 patients, 40.7%) and those without HIV infection (51 patients, 59.3%) who underwent oral examination from April through July 2024 were included. Patients were grouped according to HIV status into two groups. This study evaluated the basic demographic characteristics, laboratory measurements, especially CD4 counts, oral hygiene, and the presence of dental and periodontal lesions. The dentition status was assessed using the values of decay teeth (DT), filled teeth (FT), and missing teeth (MT), presented as DMFT. The periodontal status was evaluated through a periodontal probe measuring community periodontal index (CPI) and loss of attachment (LOA), as recommended by the World Health Organization's Oral Health Assessment Form 2013. The Pearson's correlation coefficient (r) was used to evaluate the correlation between the levels of CD4+ and DMFT, CD4+ and CPI, CD4+ and LOA, CD4+/lymphocyte percentage (CD4%) and DMFT, CD4% and CPI, and CD4% and LOA. P-values ≤0.05 were considered statistically significant. Results HIV-infected patients had a worse dentition status, with higher DT, higher MT, and higher DMFT index values (9.71 ± 6.72 vs. 5.96 ± 4.49, p = 0.003) compared to those without HIV. HIV-infected patients also had a worse periodontal status, with higher CPI (2.63 ± 1.06 vs. 0.94 ± 0.68) and LOA (2.57 ± 1.06 vs. 0.94 ± 0.68) compared to those without HIV. An important negative correlation was found between CD4+ and dentition and periodontal status. A lower level of CD4+ was correlated with a higher DMFT (r = -0.52, p = 0.01, CPI (r = -0.38, p = 0.024, and LOA (r = -0.37, p = 0.029). Conclusions HIV-infected patients manifest a worse dentition and periodontal status, with the worsening strongly correlated with the initial CD4+ levels. Periodontal disease may serve as a significant clinical indicator for the early diagnosis of HIV and its progression. Dental professionals should be vigilant in assessing periodontal health, especially in high-risk populations, as it may prompt timely testing and intervention for HIV infection.