title: Human cytomegalovirus-associated periodontitis in renal transplant patients.
abstract: BACKGROUND
  Human cytomegalovirus (HCMV) infection is associated with renal transplant failure. Periodontal pockets may be reservoirs for HCMV replication.
  
  
  OBJECTIVE
  This study was done to determine active HCMV replication in saliva and gingival crevicular fluid of renal transplant patients affected by periodontitis.
  
  
  METHODS
  HCMV pp67-mRNA amplification was analyzed in oral fluids of 38 transplant recipients at 6 months' posttransplantation. Patients received antiviral therapy until 3 months' posttransplantation. The HCMV-positive cell line VR-977 was the positive control, and oral fluids from healthy volunteers served as the negative control. Periodontitis was diagnosed by clinical examination. Serum HCMV IgG and IgM were analyzed to differentiate recent and latent infection.
  
  
  RESULTS
  Prevalence of gingival overgrowth was 68.4%. HCMV gene transcripts were detected in the saliva of 21% and the gingival crevicular fluid of 18% of patients. All patients (100%) with HCMV pp67-mRNA detected in saliva demonstrated clinical manifestations of viral infection, as did 86% of patients with HCMV pp67-mRNA detected in the gingival crevicular fluid. Serum IgM was positive in 7.9% of patients and IgG in 65.8%; however, associations with active mRNA replication were not statistically significant.
  
  
  CONCLUSIONS
  Renal transplant patients affected by periodontitis are at risk of viral replication within the periodontal tissues despite antiviral therapy. This study suggests that use of HCMV pp67-mRNA detection in saliva and gingival crevicular fluid provides markers of active viral infection, and evidence for a link between HCMV-associated periodontitis and renal transplant complications.
authors.affiliation: School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089-0641, USA.
authors.forename: H
authors.initials: H
authors.lastname: Nowzari
authors.forename: M G
authors.initials: MG
authors.lastname: Jorgensen
authors.forename: S
authors.initials: S
authors.lastname: Aswad
authors.forename: N
authors.initials: N
authors.lastname: Khan
authors.forename: E
authors.initials: E
authors.lastname: Osorio
authors.forename: A
authors.initials: A
authors.lastname: Safarian
authors.forename: H
authors.initials: H
authors.lastname: Shidban
authors.forename: S
authors.initials: S
authors.lastname: Munroe
mesh_terms: D000328:Adult; D000368:Aged; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D005260:Female; D005891:Gingivitis / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000453:epidemiology / Q000821:virology*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D012333:RNA, Messenger / Q000235:genetics; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D014158:Transcription, Genetic; D014779:Virus Replication
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012333:RNA, Messenger; D012367:RNA, Viral