Oral health outcomes in an HIV cohort with comorbidities- implementation roadmap for a longitudinal prospective observational study

BMC Oral Health. 2023 Oct 17;23(1):763. doi: 10.1186/s12903-023-03527-5.

Abstract

Background: Long-term antiretroviral therapy (ART) perpetually suppresses HIV load and has dramatically altered the prognosis of HIV infection, such that HIV is now regarded as a chronic disease. Side effects of ART in Patients With HIV (PWH), has introduced new challenges including "metabolic" (systemic) and oral complications. Furthermore, inflammation persists despite great viral load suppression and normal levels of CD4+ cell count. The impact of ART on the spectrum of oral diseases among PWH is often overlooked relative to other systemic complications. There is paucity of data on oral complications associated with ART use in PWH. This is in part due to limited prospective longitudinal studies designed to better understand the range of oral abnormalities observed in PWH on ART.

Methods: We describe here the study design, including processes associated with subject recruitment and retention, study visit planning, oral health assessments, bio-specimen collection and preprocessing procedures, and data management and statistical plan.

Discussion: We present a procedural roadmap that could be modelled to assess the extent and progression of oral diseases associated with ART in PWH. We also highlight the rigors and challenges associated with our ongoing participant recruitment and retention. A rigorous prospective longitudinal study requires proper planning and execution. A great benefit is that large data sets are collected and biospecimen repository can be used to answer more questions in future studies including genetic, microbiome and metabolome-based studies.

Trial registration: National Institute of Health Clinical Trials Registration (NCT) #: NCT04645693.

Keywords: Dental caries; HIV; Inflammation; Non-infectious comorbid conditions; Oral health; Periodontal disease.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-HIV Agents* / adverse effects
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • Humans
  • Longitudinal Studies
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Viral Load

Substances

  • Anti-HIV Agents

Associated data

  • ClinicalTrials.gov/NCT04645693