Periodontitis and Cytomegalovirus Associate With Atherosclerosis Among HIV Patients After 5 Years on ART
OBJECTIVES:Atherosclerosis has been linked with periodontitis in the general population and with persistent immune activation and a high burden of cytomegalovirus (CMV) in HIV patients responding to antiretroviral therapy (ART). Here, we assess risk factors for cardiovascular changes in younger HIV...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2020-10, Vol.85 (2), p.195-200 |
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| creator | Wulandari, Endah A. T. Wijaya, Ika Prasetya Karim, Birry Ariyanto, Ibnu Tanudjaja, Selita Agnes Lee, Silvia Price, Patricia |
| description | OBJECTIVES:Atherosclerosis has been linked with periodontitis in the general population and with persistent immune activation and a high burden of cytomegalovirus (CMV) in HIV patients responding to antiretroviral therapy (ART). Here, we assess risk factors for cardiovascular changes in younger HIV patients representative of patient populations in Asia.
STUDY DESIGN:HIV-infected adults (n = 82) with 0.05). After 5 years on ART, right and left cIMT were greater in HIV patients with periodontitis (P = 0.02, 0.006, respectively). Moreover, cIMT values were higher in patients with periodontitis (P = 0.05–0.01) than in equivalent controls. Simple linear regressions showed that patients with periodontitis had greater right (P = 0.01) and left (P = 0.004) cIMT than those without periodontitis. Multiple linear regressions showed that periodontitis and CMV antibody levels optimally predicted poor right and left cIMT (Adjusted R = 0.36, P = 0.0013; Adjusted R = 0.40, P = 0.001, respectively).
CONCLUSIONS:Our data identify periodontitis and CMV as independent predictors of atherosclerosis in young adult HIV patients. |
| doi_str_mv | 10.1097/QAI.0000000000002417 |
| format | Article |
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STUDY DESIGN:HIV-infected adults (n = 82) with <200 CD4 T-cells/μl were examined as they began ART at Cipto Mangunkusumo Hospital, Jakarta, and after 3 months. 32 patients were re-assessed after 5 years, alongside 32 age-matched healthy controls.
METHODS:We assessed the community periodontal index of treatment needs, carotid -thickness (cIMT), plasma markers of immune activation (using commercial enzyme-linked immunosorbent assay) and CMV antibodies by in-house enzyme-linked immunosorbent assay.
RESULTS:Periodontitis persisted in 16/32 patients after 5 years and was potentiated by greater age (P = 0.03) and poor oral hygiene (P = 0.05), with no effect of smoking, pulmonary tuberculosis, oral candidiasis, or low CD4 T-cell counts (P > 0.05). After 5 years on ART, right and left cIMT were greater in HIV patients with periodontitis (P = 0.02, 0.006, respectively). Moreover, cIMT values were higher in patients with periodontitis (P = 0.05–0.01) than in equivalent controls. Simple linear regressions showed that patients with periodontitis had greater right (P = 0.01) and left (P = 0.004) cIMT than those without periodontitis. Multiple linear regressions showed that periodontitis and CMV antibody levels optimally predicted poor right and left cIMT (Adjusted R = 0.36, P = 0.0013; Adjusted R = 0.40, P = 0.001, respectively).
CONCLUSIONS:Our data identify periodontitis and CMV as independent predictors of atherosclerosis in young adult HIV patients.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000002417</identifier><identifier>PMID: 32541382</identifier><language>eng</language><publisher>United States: JAIDS Journal of Acquired Immune Deficiency Syndromes</publisher><subject>Activation ; Adult ; Anti-HIV Agents - therapeutic use ; Antibodies ; Antibodies, Viral - blood ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Arteriosclerosis ; Asia ; Atherosclerosis ; Atherosclerosis - complications ; Biomarkers - blood ; Candidiasis ; Candidiasis, Oral ; Cardiovascular diseases ; Carotid Arteries ; Carotid Intima-Media Thickness ; CD4 antigen ; CD4 Lymphocyte Count ; Cytomegalovirus ; Cytomegalovirus Infections - complications ; Enzyme-linked immunosorbent assay ; Enzymes ; Female ; Gum disease ; Health risks ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Hygiene ; Immune response ; Lymphocytes T ; Male ; Middle Aged ; Oral Hygiene ; Patients ; Periodontitis ; Periodontitis - complications ; Population studies ; Public health ; Risk analysis ; Risk Factors ; Surveys and Questionnaires ; T-Lymphocytes - immunology ; Tuberculosis ; Young Adult ; Young adults</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2020-10, Vol.85 (2), p.195-200</ispartof><rights>JAIDS Journal of Acquired Immune Deficiency Syndromes</rights><rights>Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Ovid Technologies Oct 1, 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4577-b9526fdd2ad5451b78461ca7836e224f59ed1fcbbcf52478d45ccee7c24e97c83</citedby><cites>FETCH-LOGICAL-c4577-b9526fdd2ad5451b78461ca7836e224f59ed1fcbbcf52478d45ccee7c24e97c83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf><![CDATA[$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&PDF=y&D=ovft&AN=00126334-202010010-00010$$EPDF$$P50$$Gwolterskluwer$$H]]></linktopdf><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-202010010-00010$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,780,784,4609,27924,27925,64666,65461</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32541382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wulandari, Endah A. T.</creatorcontrib><creatorcontrib>Wijaya, Ika Prasetya</creatorcontrib><creatorcontrib>Karim, Birry</creatorcontrib><creatorcontrib>Ariyanto, Ibnu</creatorcontrib><creatorcontrib>Tanudjaja, Selita Agnes</creatorcontrib><creatorcontrib>Lee, Silvia</creatorcontrib><creatorcontrib>Price, Patricia</creatorcontrib><title>Periodontitis and Cytomegalovirus Associate With Atherosclerosis Among HIV Patients After 5 Years on ART</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>OBJECTIVES:Atherosclerosis has been linked with periodontitis in the general population and with persistent immune activation and a high burden of cytomegalovirus (CMV) in HIV patients responding to antiretroviral therapy (ART). Here, we assess risk factors for cardiovascular changes in younger HIV patients representative of patient populations in Asia.
STUDY DESIGN:HIV-infected adults (n = 82) with <200 CD4 T-cells/μl were examined as they began ART at Cipto Mangunkusumo Hospital, Jakarta, and after 3 months. 32 patients were re-assessed after 5 years, alongside 32 age-matched healthy controls.
METHODS:We assessed the community periodontal index of treatment needs, carotid -thickness (cIMT), plasma markers of immune activation (using commercial enzyme-linked immunosorbent assay) and CMV antibodies by in-house enzyme-linked immunosorbent assay.
RESULTS:Periodontitis persisted in 16/32 patients after 5 years and was potentiated by greater age (P = 0.03) and poor oral hygiene (P = 0.05), with no effect of smoking, pulmonary tuberculosis, oral candidiasis, or low CD4 T-cell counts (P > 0.05). After 5 years on ART, right and left cIMT were greater in HIV patients with periodontitis (P = 0.02, 0.006, respectively). Moreover, cIMT values were higher in patients with periodontitis (P = 0.05–0.01) than in equivalent controls. Simple linear regressions showed that patients with periodontitis had greater right (P = 0.01) and left (P = 0.004) cIMT than those without periodontitis. Multiple linear regressions showed that periodontitis and CMV antibody levels optimally predicted poor right and left cIMT (Adjusted R = 0.36, P = 0.0013; Adjusted R = 0.40, P = 0.001, respectively).
CONCLUSIONS:Our data identify periodontitis and CMV as independent predictors of atherosclerosis in young adult HIV patients.</description><subject>Activation</subject><subject>Adult</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibodies</subject><subject>Antibodies, Viral - blood</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Arteriosclerosis</subject><subject>Asia</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis - complications</subject><subject>Biomarkers - blood</subject><subject>Candidiasis</subject><subject>Candidiasis, Oral</subject><subject>Cardiovascular diseases</subject><subject>Carotid Arteries</subject><subject>Carotid Intima-Media Thickness</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus Infections - complications</subject><subject>Enzyme-linked immunosorbent assay</subject><subject>Enzymes</subject><subject>Female</subject><subject>Gum disease</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Immune response</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oral Hygiene</subject><subject>Patients</subject><subject>Periodontitis</subject><subject>Periodontitis - complications</subject><subject>Population studies</subject><subject>Public health</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Surveys and Questionnaires</subject><subject>T-Lymphocytes - immunology</subject><subject>Tuberculosis</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUcFO3TAQtBCoUNo_QMgS51DbWcfOMXqi5UlIhQqoOEWOsyGBvBhsp4i_r58eVIgD9WHtXc2MtTOEHHB2zFmpvl1Uy2P25gjgaovs8RIgU1rDdnpLITPgudwln0O4Y4wXAOUnspsLmcZa7JH-HP3gWjfFIQ6Bmqmli-foVnhrRvdn8HOgVQjODiYi_T3EnlaxR--CHdc1UaqVm27p6fKanps44BTTqIvoqaQ3aHygbqLVr8svZKczY8CvL_c-ufp-crk4zc5-_lguqrPMglQqa0opiq5thWklSN4oDQW3Rum8QCGgkyW2vLNNYzspQOkWpLWIygrAUlmd75Ojje6Dd48zhljfudlP6ctaSKagUKDZhyhIHpXJRpVQsEHZtGrw2NUPflgZ_1xzVq9DqFMI9fsQEu3wRXxuVtj-I726ngB6A3hyY3Iq3I_zE_q6RzPG_n_a8AE1JSyKPIdMMMF46ljG1jX_CxaXodM</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Wulandari, Endah A. T.</creator><creator>Wijaya, Ika Prasetya</creator><creator>Karim, Birry</creator><creator>Ariyanto, Ibnu</creator><creator>Tanudjaja, Selita Agnes</creator><creator>Lee, Silvia</creator><creator>Price, Patricia</creator><general>JAIDS Journal of Acquired Immune Deficiency Syndromes</general><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope></search><sort><creationdate>20201001</creationdate><title>Periodontitis and Cytomegalovirus Associate With Atherosclerosis Among HIV Patients After 5 Years on ART</title><author>Wulandari, Endah A. T. ; Wijaya, Ika Prasetya ; Karim, Birry ; Ariyanto, Ibnu ; Tanudjaja, Selita Agnes ; Lee, Silvia ; Price, Patricia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4577-b9526fdd2ad5451b78461ca7836e224f59ed1fcbbcf52478d45ccee7c24e97c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Activation</topic><topic>Adult</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antibodies</topic><topic>Antibodies, Viral - blood</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Arteriosclerosis</topic><topic>Asia</topic><topic>Atherosclerosis</topic><topic>Atherosclerosis - complications</topic><topic>Biomarkers - blood</topic><topic>Candidiasis</topic><topic>Candidiasis, Oral</topic><topic>Cardiovascular diseases</topic><topic>Carotid Arteries</topic><topic>Carotid Intima-Media Thickness</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus Infections - complications</topic><topic>Enzyme-linked immunosorbent assay</topic><topic>Enzymes</topic><topic>Female</topic><topic>Gum disease</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Immune response</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oral Hygiene</topic><topic>Patients</topic><topic>Periodontitis</topic><topic>Periodontitis - complications</topic><topic>Population studies</topic><topic>Public health</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Surveys and Questionnaires</topic><topic>T-Lymphocytes - immunology</topic><topic>Tuberculosis</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wulandari, Endah A. T.</creatorcontrib><creatorcontrib>Wijaya, Ika Prasetya</creatorcontrib><creatorcontrib>Karim, Birry</creatorcontrib><creatorcontrib>Ariyanto, Ibnu</creatorcontrib><creatorcontrib>Tanudjaja, Selita Agnes</creatorcontrib><creatorcontrib>Lee, Silvia</creatorcontrib><creatorcontrib>Price, Patricia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wulandari, Endah A. T.</au><au>Wijaya, Ika Prasetya</au><au>Karim, Birry</au><au>Ariyanto, Ibnu</au><au>Tanudjaja, Selita Agnes</au><au>Lee, Silvia</au><au>Price, Patricia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Periodontitis and Cytomegalovirus Associate With Atherosclerosis Among HIV Patients After 5 Years on ART</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>85</volume><issue>2</issue><spage>195</spage><epage>200</epage><pages>195-200</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><abstract>OBJECTIVES:Atherosclerosis has been linked with periodontitis in the general population and with persistent immune activation and a high burden of cytomegalovirus (CMV) in HIV patients responding to antiretroviral therapy (ART). Here, we assess risk factors for cardiovascular changes in younger HIV patients representative of patient populations in Asia.
STUDY DESIGN:HIV-infected adults (n = 82) with <200 CD4 T-cells/μl were examined as they began ART at Cipto Mangunkusumo Hospital, Jakarta, and after 3 months. 32 patients were re-assessed after 5 years, alongside 32 age-matched healthy controls.
METHODS:We assessed the community periodontal index of treatment needs, carotid -thickness (cIMT), plasma markers of immune activation (using commercial enzyme-linked immunosorbent assay) and CMV antibodies by in-house enzyme-linked immunosorbent assay.
RESULTS:Periodontitis persisted in 16/32 patients after 5 years and was potentiated by greater age (P = 0.03) and poor oral hygiene (P = 0.05), with no effect of smoking, pulmonary tuberculosis, oral candidiasis, or low CD4 T-cell counts (P > 0.05). After 5 years on ART, right and left cIMT were greater in HIV patients with periodontitis (P = 0.02, 0.006, respectively). Moreover, cIMT values were higher in patients with periodontitis (P = 0.05–0.01) than in equivalent controls. Simple linear regressions showed that patients with periodontitis had greater right (P = 0.01) and left (P = 0.004) cIMT than those without periodontitis. Multiple linear regressions showed that periodontitis and CMV antibody levels optimally predicted poor right and left cIMT (Adjusted R = 0.36, P = 0.0013; Adjusted R = 0.40, P = 0.001, respectively).
CONCLUSIONS:Our data identify periodontitis and CMV as independent predictors of atherosclerosis in young adult HIV patients.</abstract><cop>United States</cop><pub>JAIDS Journal of Acquired Immune Deficiency Syndromes</pub><pmid>32541382</pmid><doi>10.1097/QAI.0000000000002417</doi><tpages>6</tpages></addata></record> |
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| subjects | Activation Adult Anti-HIV Agents - therapeutic use Antibodies Antibodies, Viral - blood Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Arteriosclerosis Asia Atherosclerosis Atherosclerosis - complications Biomarkers - blood Candidiasis Candidiasis, Oral Cardiovascular diseases Carotid Arteries Carotid Intima-Media Thickness CD4 antigen CD4 Lymphocyte Count Cytomegalovirus Cytomegalovirus Infections - complications Enzyme-linked immunosorbent assay Enzymes Female Gum disease Health risks HIV HIV Infections - complications HIV Infections - drug therapy Human immunodeficiency virus Humans Hygiene Immune response Lymphocytes T Male Middle Aged Oral Hygiene Patients Periodontitis Periodontitis - complications Population studies Public health Risk analysis Risk Factors Surveys and Questionnaires T-Lymphocytes - immunology Tuberculosis Young Adult Young adults |
| title | Periodontitis and Cytomegalovirus Associate With Atherosclerosis Among HIV Patients After 5 Years on ART |
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