Non-Surgical Periodontal Treatment Outcomes in Patients with HIV Under Antiretroviral Therapy: A Systematic Review

Background/Objectives: This systematic review aimed to evaluate the clinical and immunological outcomes of non-surgical periodontal therapy (NSPT) in HIV-positive patients with periodontitis. Methods: Systematic search on four databases (PubMed, Scopus, Web of Science, Cochrane Library) and the gray literature was completed through December 2025. A comprehensive set of clinical parameters and immunological markers were assessed. Three studies met the inclusion criteria and were included in the final synthesis and qualitative analysis. Extracted outcomes included clinical periodontal parameters (PPD, CAL, BoP, PI, GBI, BI) and immunological markers (viral load, CD4+ lymphocyte count, CD4/CD8 ratio, salivary LF, salivary HST, GCF LF, GCF HST). Results: With a very low level of certainty, NSPT was generally associated with significant improvements in clinical periodontal parameters compared to before treatment measurements and HIV-negative individuals. Improvements in immunological status were also reported. Heterogeneity of study designs and reporting standards limited this study's quantitative analysis. Conclusions: NSPT demonstrates beneficial clinical and immunological outcomes in people living with HIV. However, the very low level of certainty in the available data limits confidence in changes in periodontal status and immune system reconstitution following NSPT in this population; therefore, the findings remain inconclusive and should be interpreted with caution.