title: The herpesvirus-Porphyromonas gingivalis-periodontitis axis.
abstract: OBJECTIVE
  Members of the herpesvirus family have accumulated considerable support for a role in severe types of periodontitis. This study aimed to examine whether human cytomegalovirus (HCMV), Epstein-Barr virus type 1 (EBV-1) or herpes simplex virus (HSV) together with the major periodontopathic bacterium Porphyromonas gingivalis might interact in the pathogenesis of periodontal breakdown.
  
  
  METHODS
  Sixteen subjects each contributed paper point samples from two progressing and two stable periodontitis lesions, as determined by ongoing loss of probing attachment. Polymerase chain reaction methodology was used to identify subgingival herpesviruses, P. gingivalis and other bacterial pathogens. Chi-squared tests and multivariate logistic regression were employed to identify statistical associations between herpesviruses, periodontopathic bacteria and clinical variables.
  
  
  RESULTS
  HCMV and HSV were both significant predictors of the presence of subgingival P. gingivalis. In turn, P. gingivalis was positively associated with periodontitis active disease, probing attachment level, probing pocket depth, gingival bleeding upon probing and patient age. EBV-1 was not linked to P. gingivalis, although the virus was predictive of periodontitis active disease. The periodontitis disease risk associated with herpesvirus-P. gingivalis combinations depended on both site-specific and subject-specific factors.
  
  
  CONCLUSIONS
  The present data of aggressive periodontitis implicate HCMV, HSV and P. gingivalis as either cofactors in its etiology or triggers of relapses. Further studies are needed to determine the spectrum of periodontopathogenicity of herpesviruses and effective management of these viruses in periodontal sites.
authors.affiliation: University of Southern California, School of Dentistry, Los Angeles, CA 90089-0641, USA. jslots@usc.edu
authors.forename: J
authors.initials: J
authors.lastname: Slots
authors.forename: J J
authors.initials: JJ
authors.lastname: Kamma
authors.forename: C
authors.initials: C
authors.lastname: Sugar
mesh_terms: D000328:Adult; D000367:Age Factors; D016866:Bacteroidaceae Infections / Q000382:microbiology*; D016009:Chi-Square Distribution; D003587:Cytomegalovirus / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000821:virology; D005260:Female; D005884:Gingival Hemorrhage / Q000382:microbiology / Q000821:virology; D006564:Herpesviridae / Q000145:classification*; D006566:Herpesviridae Infections / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017622:Periodontal Attachment Loss / Q000382:microbiology / Q000821:virology; D010514:Periodontal Pocket / Q000382:microbiology / Q000821:virology; D010518:Periodontitis / Q000382:microbiology* / Q000821:virology; D016966:Porphyromonas gingivalis / Q000502:physiology*; D018570:Risk Assessment; D018139:Simplexvirus / Q000502:physiology; D013283:Stomatitis, Herpetic / Q000821:virology