Oral and systemic factors associated with increased levels of human immunodeficiency virus type 1 RNA in saliva.
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.
Shugars
D C
DC
Department of Dental Ecology, UNC School of Dentistry, Chapel Hill, NC 27599-7450, USA.
Slade
G D
GD
Patton
L L
LL
Fiscus
S A
SA
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
D012367:RNA, Viral