Poor Oral Health-Related Quality of Life and Frailty Among PLWHIV: A Cross-Sectional Study.

Abstract

Aims: This study aimed to explore the association between frailty and pre-frailty in people living with human immunodeficiency virus (PLWHIV), focusing on their oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL).

Materials and methods: A cross-sectional study was conducted with 184 PLWHIV. Frailty status was assessed using Fried's frailty criteria, categorizing participants as robust, pre-frail, or frail. The oral health profile was evaluated using the World Health Organization and European Association of Public Dental Health criteria. OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14), while HRQoL was measured using the 36-Item Short-Form Health Survey version 2 (SF-36v2). Descriptive statistics were calculated, and associations were analyzed using Spearman's correlation and one-way ANOVA, with significance set at P ≤ 0.05.

Results: The pre-frail and frail PLWHIV groups reported significantly lower HRQoL scores across all domains compared to the robust group. Additionally, robust PLWHIV exhibited better oral health outcomes, with higher mean OHIP-14 scores (P = 0.005), attributed to fewer missing teeth (P = 0.019) and a higher number of filled teeth (P = 0.031). The total OHIP-14 score showed a moderate negative correlation with various SF-36v2 domains, particularly in the pre-frail and frail groups. Specifically, physical pain and physical disability subdomains of HRQoL were most affected by poorer OHRQoL.

Conclusions: Frail and pre-frail PLWHIV demonstrated significantly poorer OHRQoL compared to robust PLWHIV, with a particular impact on physical pain and physical disability. A negative correlation between OHRQoL and HRQoL was evident, especially in the frail and pre-frail groups, highlighting the interrelationship between oral health and overall well-being in this population. Clinically, this suggests that improving OHRQoL could be an essential component of healthcare for frail and pre-frail PLWHIV, as enhancing oral health may positively influence their general health outcomes. Targeted interventions to manage frailty and improve oral health are needed to enhance both OHRQoL and HRQoL in this vulnerable group.