[HIV positive patients and utilization of dental health services]

To determine the level of dental health services utilization by HIV-positive patients. In this study we used a proportional random sampling method to select 230 HIV-positive patients from three HIV counseling centers. An anonymous questionnaire was completed for each patient. The total demand for dental services was 165. The rate of demand was 47.9% and the rate of utilization was estimated 75.9%. Most patients [56%] did not have insurance. Only 60% of these individuals notified the health workers of their HIV status. The most common reason for not demanding services was high cost, and the most common reason of non-utilization was the refusal by health workers to provide services. The main reason for not reporting the HIV-positive status was fear of rejection by the dentist. Inadequate insurance coverage and poverty might result in decreased access to dental health in HIV-positive individuals. In addition there is need to improve knowledge of HIV in dentists and change their attitudes and practices in order to increase utilization of dental services by HIV-positive patients

[Assessment of periodontal condition among Iranian HIV+ patients during 2005]

There is no precise information of periodontal status in HIV-infected Iranian patients, so this descriptive study was performed to assess periodontal condition among HIV-infected patients referred to the three HIV patients medical centers in Tehran during 2005. One hundred and eighteen known HIV+ patients, confirmed by ELISA, Western blot and clinical examination, participated in this study. Data on age, gender, level of education, smoking, marital status, type of addiction, type of antiretroviral medicine, their dose and duration of consumption, etiology of their disease, and level of CD4 were recorded. None had surgery on neck and mouth. MGI, PI [Shick and Ash], PD, and CAL were measured on 6 surfaces of each of the Ramjord's teeth. Data analysis was done by SPSS, SAS, generalized estimated equation, Hotte Ling's multivariate model, Pearson and Spearman correlation tests. One hundred and fourteen men [96.6%] and 4 women [3.4%] with mean age of 33.6 +/- 6.49 participated in the study. 14 persons [27%] had CD4<200, 29 patients [55.7%] had 200500. Mean MGI, PI, and PD were 1.33 +/- 0.41, 2.8 +/- 0.18, and 1.66 +/- 0.98 respectively. There was no difference between CD4 and MGI and PI [P=0.1 and P=0.2], but in patients with CD4<200, CAL was significantly higher than the other two CD4 groups [P=0.02]. PD in this group was significantly higher than the other CD4 groups [P=0.01]. MGI and PI level in the study group were high which indicates poor oral hygiene. CAL was increased with immune system deficiency which indicates the influence of HIV-infection as a risk factor on the periodontal disease severity

Epidemiology and risk factors of 377 AIDS [HIV infected] patients

Oral manifestations of HIV infection are common and include oral lesions and novel presentations of previously known opportunistic diseases. Some risk factors are significantly contributed to probability of developing opportunistic infection of oral candidiasis. We have performed the current survey to evaluate their role in Iranian patients with HIV infection. Totally, 377 documented HIV infected patients were included. Oral candidiasis was investigated with clinical observation, direct smear, and culture. Meanwhile, CD4 count was determined at the first visit and following antiretroviral therapy. The study population included 316 males and 60 females with a mean age of 36.5 +/- 8.7 years. Patients were diagnosed for a mean duration of 2.9 years. The most common route of infection transmission was shared needles [117 cases or 31%]. In serologic tests, 11 cases [2.9%] were positive for HBsAg, 206 cases [71.5%] for HCV nucleic acid and 53 cases [14.1%] for tuberculosis infection. At the first visit 52 cases [13.9%] and following HAART 31 cases [8.2%] were revealed to have oral candidiasis. Mean CD4 count in patients with oral candidiasis was significantly less than other patients [193.8 vs. 349.7 cells, P=0.0001]; however, the difference was not significant at follow up. Prompt diagnosis and treatment of HIV infection may have a significant role in prognosis and clinical course of patients with HIV infection and could decrease the rate of opportunistic infections