The Impact of Oral Health on Metabolism and Persistent Inflammation in HIV Patients on Antiretroviral Therapy (OHART)

口腔健康对接受抗逆转录病毒治疗 (OHART) 的 HIV 患者代谢和持续炎症的影响

• 批准号: 10595680
• 负责人: Temitope T Omolehinwa
• 金额: $ 74.44万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595680
• 关键词: Acquired Immunodeficiency Syndrome; Address; Affect; Aging; Anti-Retroviral Agents; Automobile Driving; Biological Response Modifiers; Candidiasis; Cardiovascular Diseases; Caring; Cells; Cessation of life; Chronic; Chronic Disease; Clinic; Coagulation Process; Combined Modality Therapy; Complex; Cytokine Activation; Data; Dental; Dental caries; Deterioration; Development; Diabetes Mellitus; Disease; Dyslipidemias; Environment; Functional disorder; Gingiva; Goals; HIV; HIV Infections; HIV diagnosis; Health; Health Status; Healthcare; Highly Active Antiretroviral Therapy; Hyperlipidemia; Immune; Individual; Infection; Inflammation; Inflammatory; Insulin Resistance; Knowledge; Link; Mediating; Mediator; Medical; Medicine; Metabolic; Metabolism; Mouth Diseases; Oral; Oral cavity; Oral health; Osteoporosis; Outcome; Parotid Gland; Pathogenicity; Patient Admission; Patient-Focused Outcomes; Patients; Periodontal Diseases; Periodontitis; Persons; Pharmaceutical Preparations; Play; Population; Prevalence; Prevention; Prevention strategy; Prognosis; Prospective Studies; Reporting; Research; Research Design; Risk; Role; Saliva; Salivary; Salivary Glands; Salivary Proteins; Severities; Source; Systemic disease; Tissues; Viral; Virus Replication; Xerostomia; antiretroviral therapy; chemokine; co-infection; cohort; comorbidity; cytokine; immune activation; immune function; improved; improved outcome; interdisciplinary approach; microbial; neurocognitive disorder; novel; novel strategies; prospective; response; saliva composition; side effect; success; systemic inflammatory response; treatment guidelines; treatment response

Patients living with HIV (PLWH) are living longer as a result of treatment with antiretroviral therapy (ART), either single agent or combined therapy (cART). Though the general outcomes of suppressing HIV is a plus, the prevalence of oral and systemic health problems in this population cannot be overemphasized nor ignored. The goal of this research is to address gaps in our knowledge of the oral health status of patients living with HIV (PLWH) who also have non communicable diseases (NCDs) in order to explore the combined effects of HIV, ART, and aging-related NCDs on the extent and progression of oral/dental conditions (e.g. caries, periodontal diseases, salivary gland dysfunction, and oral cavity coinfections). We will be employing an interdisciplinary approach to leverage expertise from both dental and medical professionals, representing a valuable opportunity to bridge the gap between oral-systemic diseases amongst PLWH. Our preliminary data showed a high caries and periodontal disease prevalence among PLWH on ART (both > 80%), as well as findings of “metabolic complications” such as cardiovascular disease (48.5%), hyperlipidemia (33.2%) and diabetes (14.9%) in this population, which makes our population an ideal cohort for a prospective and well-designed study. The central hypothesis is that the extent and progression of key oral diseases (e.g. caries, periodontal diseases and oral cavity coinfections), is associated with ART induced salivary changes (e.g. xerostomia, change in saliva composition); and are exacerbated in PLWH (>1 year ART) with NCDs, compared to PLWH without NCDs. We will also prospectively investigate the range of metabolic abnormalities observed in PLWH on ART and explore the hypothesis that poor oral health and salivary dysfunction, concurrent with these metabolic abnormalities, play a critical role in both supporting and driving chronic immune activation and inflammation in HIV infection. By 2020, it is expected that >30 million people living with HIV will have access to ART. Progress towards improving outcomes for these individuals will depend on the identification of novel strategies for the prevention and treatment of these non-AIDS- associated comorbidities. This is important in order to better understand if infection with HIV or the exposure and extended use of ART affects the prevalence and severity of these oral diseases. In addition, there is an unmet need to investigate strategies to control host-immune cART response associated with oral and systemic co-infections, and comorbidities or mediators among PLWH. These efforts could help to generate evidence for oral health treatment guidelines tailored to the needs of dental patients with HIV.

艾滋病毒感染者（PLWH）由于抗逆转录病毒疗法（ART）的治疗而活得更长， 单药或联合治疗（cART）。虽然抑制艾滋病毒的总体结果是一个加号， 这一人群的口腔和全身健康问题的普遍性无论如何强调也不为过。的 这项研究的目的是解决我们对艾滋病病毒感染者口腔健康状况的认识上的差距 （PLWH）谁也有非传染性疾病（NCD），以探讨艾滋病毒的综合影响， 抗逆转录病毒疗法和衰老相关的非传染性疾病对口腔/牙齿疾病（如龋齿、牙周病）的程度和进展的影响 疾病、唾液腺功能障碍和口腔合并感染）。我们将聘请一位跨学科的 利用牙科和医疗专业人员的专业知识的方法，代表了一个宝贵的机会 弥合感染者口腔系统疾病之间的差距。我们的初步数据显示 和牙周病患病率在PLWH ART（均> 80%），以及“代谢”的发现， 心血管疾病（48.5%）、高脂血症（33.2%）和糖尿病（14.9%）等并发症 这使得我们的人群成为前瞻性和精心设计的研究的理想队列。 中心假设是，关键口腔疾病（例如龋齿、牙周炎）的程度和进展 疾病和口腔合并感染），与ART诱导的唾液变化（例如，口干症，改变 唾液组成中）;并且与未接受非传染性疾病的PLWH相比，在患有非传染性疾病的PLWH（>1年ART）中加重 非传染性疾病我们还将前瞻性地研究ART治疗PLWH中观察到的代谢异常的范围 并探讨这一假设，即口腔健康不良和唾液功能障碍，同时与这些代谢 异常，在支持和驱动慢性免疫激活和炎症中起着关键作用。 艾滋病毒感染。 到2020年，预计将有超过3000万艾滋病毒感染者获得抗逆转录病毒治疗。 改善这些人的结果将取决于确定新的预防策略， 和治疗这些非艾滋病相关的合并症。这一点很重要，以便更好地理解， 感染艾滋病毒或接触和长期使用抗逆转录病毒治疗会影响这些口腔疾病的患病率和严重程度， 疾病此外，研究控制宿主免疫cART应答的策略的需求尚未得到满足。 与口腔和全身合并感染，以及PLWH中的共病或介质相关。这些努力 可以帮助生成证据，为口腔健康治疗指南量身定制的牙科患者的需要， 艾滋病。