# Oral immune activation and alveolar bone loss in HIV-infected postmenopausal women

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $443,800

## Abstract

PROJECT SUMMARY
There are very few controlled studies on the oral health of older HIV-infected individuals, especially
postmenopausal women. This is of particular concern in the U.S, where more than half of HIV-infected
individuals are over age 50. Our group has previously demonstrated that skeletal bone loss at the spine and
hip is greater and fracture rates higher in HIV-infected than uninfected women after menopause. Our
preliminary data also show that HIV-infected women over age 50 had greater alveolar bone loss and a trend
for fewer teeth compared to age-matched uninfected controls. However, the separate and/or combined
contribution of HIV infection and estrogen deficiency to oral immune activation and the observed alveolar bone
loss is uncertain. Therefore, the goal of this study is to determine the extent and progression of periodontal
disease in HIV-infected pre- and postmenopausal women on cART and to investigate the contribution of
periodontal immune activation to its pathogenesis. We hypothesize that HIV-infection is associated with
increased oral immune activation. Loss of the beneficial immune-modulatory effects of estrogen results in an
increased inflammatory response to periodontal pathogens, and greater alveolar bone loss after menopause.
In order to examine this, we propose three Specific Aims. Aim 1: To determine the impact of HIV infection and
menopause on periodontal health in a cross sectional study 240 HIV-infected and uninfected pre- and post-
menopausal women. HIV-infected postmenopausal women will have evidence of worsened clinical periodontal
parameters, higher GCF inflammatory biomarkers, greater alveolar bone loss and fewer teeth than uninfected
post-menopausal women, and both HIV-infected and uninfected pre-menopausal women. Aim 2: To define the
oral immune response in HIV-infected and uninfected postmenopausal women during the induction and
resolution of gingival inflammation using the experimental gingivitis model. The clinical, GCF and gingival
tissue cytokine response during induction of gingivitis will be greater, and the resolution of the inflammatory
response more attenuated in HIV-infected post-menopausal women compared to uninfected postmenopausal
women or HIV-infected women on hormone replacement therapy. Aim 3: To delineate the clinical, oral
immune, and alveolar bone response to standard-of-care periodontal treatment in HIV-infected and uninfected
postmenopausal women with moderate periodontitis. Improvements in clinical periodontal parameters, GCF
biomarkers, and alveolar bone density and microarchitecture will be less in HIV-infected than uninfected
postmenopausal women with moderate periodontitis in response to oral hygiene instruction, scaling/root
planing and periodontal maintenance. If proven correct, these studies provide rationale for investigating use of
a selective estrogen receptor modulator (SERM), as a safe and testable intervention to prevent periodontal
disease progression and/or alveolar bo...

## Key facts

- **NIH application ID:** 9850870
- **Project number:** 5R01DE026924-04
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Sunil Wadhwa
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $443,800
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9850870

## Citation

> US National Institutes of Health, RePORTER application 9850870, Oral immune activation and alveolar bone loss in HIV-infected postmenopausal women (5R01DE026924-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9850870. Licensed CC0.

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