Poor Oral Health Quality of Life Found in Frail Patients With HIV

People living with HIV (PLHIV) had poorer oral health–related quality of life (OHRQOL) when they were prefrail or frail compared with PLHIV who were robust. This especially affected physical pain and physical disability, according to a study published in Journal of International Society of Preventive and Community Dentistry.1

Although PLHIV have a longer life expectancy due to improvements in treatment methods, many PLHIV will have an increased risk of developing other chronic diseases.2 Frailty is one such chronic state, and it can lead to weight loss, slower walking speed, low levels of physical activity, weakness, and exhaustion. OHRQOL can be affected by frailty. This study aimed to evaluate the association between frailty and prefrailty in PLHIV with OHRQOL and HRQOL.

This study was performed in Brazil from March 2019 to June 2020. All participants were 18 years or older and had a viral load below 50 copies/mL. Fried’s criteria were used to diagnose frailty, which separates people into 3 categories: prefrail, frail, and robust. Unintentional weight loss of 5% body mass was defined as weight loss in relation to frailty. An electronic hand dynamometer was used to measure grip strength for a weakness measure. Exhaustion was self-reported and walking speed was measured by the patient walking for the researchers. Periodontal screenings were done to evaluate the oral health profile of the participants and OHRQOL was assessed through the Oral Health Impact Profile 14 (OHIP-14), with higher scores indicating worse OHRQOL.

People living with HIV who were frail had lower oral health–related quality of life. | Image credit: onephoto - stock.adobe.com

PLHIV 50 years and older had a 32% higher frequency of frailty compared with younger participants, with 62.3% of those older than 50 years reporting frailty compared with 47.1% of those 49 years and younger. PLHIV were 29% more likely to be frail or prefrail if they had a maximum family income of the minimum wage compared with those who had higher income.

PLHIV who were frail or prefrail had fewer mean (SD) filled teeth (4.50 [4.50] vs 6.00 [5.04]) and more missing teeth (12.76 [8.86] vs 9.70 [7.94]) compared with PLHIV who were robust. Lower mean HRQOL scores were found in all domains for PLHIV who were frail or prefrail, including higher OHIP-14 scores, compared with robust individuals(11.53 [8.98] vs 7.91 [7.19]), indicating worse OHRQOL.

There were some limitations to this study. The study had a small sample size, which can limit generalizability, and the observational design of the study prevents identification of causal associations. Future studies need to focus on the effect of OHRQOL on HRQOL and frailty in PLHIV.

The researchers concluded that “frail/prefrail [PLHIV] presented with poor OHRQOL compared to the robust [PLHIV], particularly in relation to physical pain and physical disability.” Poor HRQOL in the pre-frail/frail group was also correlated to low OHRQOL.

References

1. Santos-Lins LS, Santos MS, Amaral S, Alves CRB, Lins-Kusterer L. Poor oral health-related quality of life and frailty among PLWHIV: a cross-sectional study. J Int Soc Prevent Communit Dent. 2024;14(6):515-522. doi:10.4103/jispcd.jispcd_65_24

2. Katella K. How HIV became the virus we can treat. Yale Medicine. October 12, 2021. Accessed January 28, 2025. https://www.yalemedicine.org/news/hiv-treatable