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

艾滋病毒携带者(PLWH)由于接受抗逆转录病毒疗法(ART)治疗而寿命延长， 单药或联合治疗(CART)。尽管抑制艾滋病毒的总体结果是有利的，但 口腔和全身健康问题在这一人群中的流行无论怎么强调都不过分，也不能忽视。这个 这项研究的目标是解决我们对艾滋病毒携带者口腔健康状况的了解方面的差距 (PLWH)也患有非传染性疾病(NCDs)，以探索艾滋病毒的综合影响， 关于口腔/牙科疾病(如龋齿、牙周)的范围和进展的ART和与衰老相关的非传染性疾病 疾病、唾液腺功能障碍和口腔混合感染)。我们将采用跨学科的 利用牙科和医疗专业人员的专业知识的方法，这是一个宝贵的机会 以弥合PLWH之间口腔系统疾病之间的差距。我们的初步数据显示高龋齿 和接受抗逆转录病毒治疗的PLWH中的牙周病患病率(均为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 这使得我们的人口成为一项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(如龋齿、牙周疾病)的范围和进展 疾病和口腔混合感染)，与ART引起的唾液变化(例如口干症、变化)有关 在唾液成分中)；与没有非传染性疾病的PLWH相比，患有非传染性疾病的PLWH(&>；1年ART)会恶化 非传染性疾病。我们还将前瞻性地研究在抗逆转录病毒治疗中观察到的PLWH代谢异常的范围。 并探讨了口腔健康不良和唾液功能障碍，与这些代谢同时存在的假设 异常，在支持和推动慢性免疫激活和炎症方面发挥关键作用 艾滋病毒感染。 到2020年，预计将有3000万艾滋病毒携带者获得抗逆转录病毒治疗。取得的进展 改善这些人的结果将取决于确定新的预防策略。 以及治疗这些与艾滋病无关的合并症。这一点很重要，以便更好地了解 感染艾滋病毒或暴露和长期使用抗逆转录病毒药物会影响这些口腔疾病的患病率和严重程度 疾病。此外，还有一个尚未得到满足的需求，即研究控制宿主免疫CART反应的策略 与口腔和全身合并感染以及PLWH之间的共病或介体有关。这些努力 可以帮助为口腔健康治疗指南生成证据，以满足牙科患者的需求 爱滋病毒。

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.