title: Hyper-excretion of human immunodeficiency virus type 1 RNA in saliva.
abstract: Anatomical compartments (e.g., the reproductive tract) are reservoirs of human immunodeficiency virus type-1 (HIV-1) and potential sites of residual infection in patients receiving anti-retroviral therapy (ART). Viral hyper-excretion relative to blood is a hallmark of reservoirs. To determine whether hyper-excretion can occur in the oral cavity, we compared viral loads in blood plasma and saliva of 67 adults. Salivary viral hyperexcretion was defined as a four-fold or higher viral load in saliva than in plasma. HIV-1 RNA was detected in 79% of plasma samples, in 44% of unfiltered saliva samples, in 16% of filtered saliva samples, and in 59% of saliva-derived cell pellets. Compared with non-hyper-excretors (n = 62), hyper-excretors (n = 5) had elevated levels of viral RNA in unfiltered saliva and saliva-derived cells, HIV-associated periodontal disease, gingival inflammation, and no combination ART. Morphological characterization of cell pellets identified lymphocytes as a likely HIV-1 source. These collective findings are consistent with an oral HIV-1 reservoir in selected individuals.
authors.affiliation: School of Dentistry, University of North Carolina at Chapel Hill, 27599-7450, USA. diane_shugars@dentistry.unc.edu
authors.forename: D C
authors.initials: DC
authors.lastname: Shugars
authors.forename: L L
authors.initials: LL
authors.lastname: Patton
authors.forename: S A
authors.initials: SA
authors.lastname: Freel
authors.forename: L R
authors.initials: LR
authors.lastname: Gray
authors.forename: R T
authors.initials: RT
authors.lastname: Vollmer
authors.forename: J J
authors.initials: JJ
authors.lastname: Eron
authors.forename: S A
authors.initials: SA
authors.lastname: Fiscus
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis / Q000097:blood; D005260:Female; D005891:Gingivitis / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D012463:Saliva / Q000821:virology*; D018709:Statistics, Nonparametric; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral