(P42) Oral Health inPatients with Chronic Hepatitis B Infection vs Chronic Hepatitis B

Författare/Medförfattare

Liyan Lu[1,4], Habiba Khodir[2, 3], Susanne Cederberg[2, 3], Karin Lindahl[2, 3], Soo Aleman[2,3], Margaret Sällberg Chen[1,4] Contact: Liyan Lu

Affiliates

[1] Division of Clinical Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden. [2] Department for Medicine, Huddinge, Karolinska Institutet, Sweden. [3] Department of Infectious Diseases, Karolinska University Hospital, Sweden. [4] Tenth People’s Hospital, Tongji University, Shanghai, China.

Abstract

Background
The leading cause of chronic hepatitis B (CHB) is the decompensation of liver function and pathological change in the liver, in which the microbiota dysbiosis in oral cavity and gut played a role in the promoting the progression of the disease. The aim of this pilot study is to investigate the oral health in HBV patients no or mildliver damage. Oral health holds a dynamic microbiota, as endogenous reservoir for gutmicrobial strainsthat shape the GI microbiome in health and disease. We hypothesize it has influence on the liver disease.

Methods
Patients with chronic HBV infection undergoing regular follow-upat the Infectious Disease Clinic in Huddinge Hospital (Stockholm, Sweden) were invited to participate in this study. The participants were grouped as: Chronic HBV Infection (Group I) or Chronic Hepatitis B (Group II) according to the EASL 2017 Clinical Practice Guidelines for management of HBV infection.They were given a standardized full-mouth dental examination e.g. measurement of periodontal pocket depth (PD), decayed-missing-filled teeth (DMFT), and the mucosa conditions, as expression of their oral disease experiences. A questionnaire about their lifestyle and oral hygiene habits was included, and donation of saliva and subgingival plaque.

Results
In this ongoing prospective study, a total of 42 participants have completed saliva and blood sampling, among them 30 participants also completed a full dental examination. The cohort´s mean age is 34.3±11.9, male:female ratio1.2:1, ethnicity distribution: Asians, Caucasians, Africans (40%, 30%, 30%, respectively). When divided into Group I (Chronic HBV Infection) and Group II (Chronic Hepatitis B), the groups do not show difference in age, gender, history of infection except the BMI, virological and liver parameters. Regarding oral parameters, there was no significant difference in the magnitude of DMFT, PD, salivary secretion rate or mucosal conditions. Interestingly, the PD score in Group II is found to be positively corelated to age (r=0.9, p<0.05) and negatively correlated to HBV-DNA level (r=-0.9,p<0.05) and ALT level (r=0.9, p<0.05). The eating habit and oral hygiene habit did not show a consistent correlation with DMFT and PD.

Conclusions
Preliminary results from this ongoing prospective study indicates that presence of clinical signs of liver inflammation is not markedly associated with impaired oral health status in chronically HBV-infected individuals. But factors like age, virological and liver enzyme levels are correlated with periodontal disease development in patients with clinical signs of liver inflammation. Why this is not seen in HBV patients without liver inflammation is not clear. A larger cohort and oral microbiota comparison will shed more insights.

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