Postscaling bacteremia in HIV-associated gingivitis and periodontitis

Aseptic venipuncture was used to obtain samples of blood from 22 patients seropositive for human immunodeficiency virus (HIV) with gingivitis (HIV-G) and 19 HIV-seropositive patients with periodontitis (HIV-P), 15 and 30 minutes after the initiation of routine dental scaling and root planing. The presence of colony forming units in 1.2 ml aliquots of blood collected with the Isostate system (DuPont Isostat System, Doraville, Ga.) was assayed on trypticase soy blood agar. Six of the samples from HIV-G subjects were positive for colony forming units 15 minutes after scaling but not at 30 minutes. Similar evidence of bacteremia was found in seven of the HIV-P patients 15 minutes after scaling was initiated in this group, with no microbial growth detectable in samples obtained at 30 minutes. In two HIV-G and three HIV-P patients with demonstrable bacteremias a postoperative fever developed. For both HIV-G and HIV-P groups no significant difference was found between the absolute CD4 T-cell counts of nonbacteremic versus bacteremic patients (p greater than 0.05). These observations suggest that special provisions for antibiotic prophylaxis in this patient group may be unnecessary.