title: Oral and systemic factors associated with increased levels of human immunodeficiency virus type 1 RNA in saliva.
abstract: OBJECTIVE
  The purpose of this investigation was to quantify human immunodeficiency virus type-1 (HIV-1) RNA in saliva and plasma and identify factors associated with increased salivary viral load.
  
  
  METHODS
  Forty HIV-1-seropositive adults underwent oral examinations to assess mucosal and periodontal health. Whole saliva was evaluated for HIV-1 RNA titer and occult blood. Plasma viral load, CD4 cell count, HIV-1 staging, and antiretroviral therapy data were obtained from medical records. Associations between salivary titers and oral/systemic parameters were analyzed by means of t tests, Wilcoxon signed rank tests, Pearson's correlation coefficient, and analysis of covariance.
  
  
  RESULTS
  Forty-two percent of the subjects had detectable salivary HIV-1 RNA. Oral titers were highly correlated with plasma viral levels (r = 0.51, P <.01). HIV-associated periodontal disease (in particular, linear gingival erythema), severe gingival inflammation, and absence of antiretroviral therapy were associated with high salivary titers (P <.01).
  
  
  CONCLUSIONS
  Substantial quantities of HIV-1 can be shed in the oral cavity, particularly when inflammatory conditions are present. Salivary titer may be a useful indicator of systemic viral burden.
authors.affiliation: Department of Dental Ecology, UNC School of Dentistry, Chapel Hill, NC 27599-7450, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Shugars
authors.forename: G D
authors.initials: GD
authors.lastname: Slade
authors.forename: L L
authors.initials: LL
authors.lastname: Patton
authors.forename: S A
authors.initials: SA
authors.lastname: Fiscus
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000821:virology; D015497:HIV-1 / Q000235:genetics* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010949:Plasma / Q000821:virology; D012367:RNA, Viral / Q000032:analysis*; D012463:Saliva / Q000737:chemistry* / Q000821:virology; D015144:Southeastern United States; D019562:Viral Load / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D012367:RNA, Viral