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: 10369019
• 负责人: Temitope T Omolehinwa
• 金额: $ 87.53万
• 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/10369019
• 关键词: Address; Affect; Aging; Anti-Retroviral Agents; Automobile Driving; Biological Response Modifiers; Candidiasis; Cardiovascular Diseases; Caring; Cessation of life; Chronic; Chronic Disease; Clinic; Coagulation Process; Complex; Cytokine Activation; Data; Dental; Dental caries; Deterioration; Development; Diabetes Mellitus; Disease; Dyslipidemias; Effector Cell; Environment; Functional disorder; Gingiva; Goals; HIV; HIV Infections; HIV antiretroviral; HIV diagnosis; Health; Health Status; Healthcare; Highly Active Antiretroviral Therapy; Hyperlipidemia; Immune; Individual; Infection; Inflammation; Inflammatory; Insulin Resistance; Knowledge; Link; Mediating; Mediator of activation protein; Medical; Medicine; Metabolic; Metabolism; Mouth Diseases; Oral; Oral cavity; Oral health; Osteoporosis; Outcome; Parotid Gland; Pathogenicity; Patient-Focused Outcomes; Patients; Periodontal Diseases; Periodontitis; Persons; Pharmaceutical Preparations; Play; Population; Prevalence; Prevention; Prevention strategy; Prognosis; Prospective Studies; Research; Research Design; Risk; Role; Saliva; Salivary; Salivary Glands; Salivary Proteins; Severities; Source; Systemic disease; Tissues; Viral; 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.

由于抗逆转录病毒疗法（ART）的治疗，艾滋病毒感染者（PLWH）的寿命延长了。