The Association Between GCF VEGF and Periodontitis in HIV⁺ Patients

Objectives: The aim of this study was to investigate the association between vascular endothelial growth factor (VEGF) in gingival crevicular fluid (GCF) and periodontal status in HIV⁺ patients.

Methods: Medical and demographic variables including age, race, cigarette smoking, oral hygiene practices, current CD4 cell count and viral load values were recorded. Clinical measurements including gingival index (GI), plaque index, bleeding index, probing depth (PD), attachment loss (AL) and GCF samples were taken from 3 periodontitis sites (GI>0, PD>4mm, AL>2mm), 3 gingivitis sites (GI>0, PD<4mm, AL=0), 2 healthy sites (including sites with gingival recession, GI=0; PD<4mm, AL<3mm) of each of the six patients at baseline and 6-month visits by means of paper strips. GCF VEGF levels were determined by sandwich enzyme-linked immunosorbent assays. SAS statistical software package was used to analyze the data.

Results: The mean amounts of VEGF in diseased sites were significantly higher in gingivitis and periodontitis sites than in healthy sites (p<0.0001). An active site was defined as a site which had 2 mm or more attachment loss during the 6-month study period. GCF levels of VEGF were significantly correlated with probing depth, attachment loss, CD4, viral load, age, and smoking pack years at baseline and 6-month visits (0.0001<p<0.0006).

Conclusions: The results of the present study demonstrated that the GCF VEGF levels increased proportionally with the progression of periodontal disease and associated with the immune status. These data indicate that high GCF levels of VEGF in HIV⁺ patients may be considered as a risk indicator for periodontitis. A longitudinal study involving a larger sample size is needed to confirm the above findings.

This study was supported by NIDCR grant DE12417 and University of the Pacific Arthur A. Dugoni School of Dentistry.