title: High prevalence of multiple human herpesviruses in saliva from human immunodeficiency virus-infected persons in the era of highly active antiretroviral therapy.
abstract: Human immunodeficiency virus (HIV) infection is associated with an increased risk for human herpesviruses (HHVs) and their related diseases. Methods for limiting the transmission of HHVs require a better understanding of the prevalence and infectiousness of oral HHVs in HIV-infected patients. We performed quantitative PCR to investigate the prevalence, quantity, risk, and correlates of salivary HHVs from 58 HIV-seropositive individuals in a case control study. HHVs were significantly more prevalent in the salivas of HIV-seropositive persons than in those of the controls (odds ratios [ORs], 4.2 to 26.2; P<or=0.008). In HIV-infected patients, Epstein-Barr virus (EBV), human herpesvirus 8 (HHV-8), cytomegalovirus (CMV), and herpes simplex virus type 1 (HSV-1) were detected in 90%, 57%, 31% and 16% of samples, respectively, compared with 48%, 24%, 2%, and 2%, respectively, of samples from controls. Multiple HHVs were observed in 71% of HIV-seropositive persons and only 16% of controls (OR, 13.0; 95% confidence interval, 5.29 to 32.56). HIV-positive patients had significantly higher EBV loads than HIV-negative persons (P<0.0001). HIV-infected patients with CD4 counts above 200 cells/microl had increased probability for having HHV-8 in saliva (P=0.009) compared with patients whose counts were less than 200. In contrast, HSV-1, EBV, and CMV were detected more often when CD4 counts were low. High salivary HHV loads were detected for those (n=7) with oral lesions. These findings suggest that saliva is a potential risk factor for the acquisition of multiple HHVs, and several host factors may function to accelerate HHV reactivation or replication in patients with HIV infection.
authors.affiliation: Department of Microbiology, Immunology & Molecular Genetics, College of Medicine, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0297, USA. cmiller@uky.edu
authors.forename: Craig S
authors.initials: CS
authors.lastname: Miller
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Berger
authors.forename: Yunanan
authors.initials: Y
authors.lastname: Mootoor
authors.forename: Sergei A
authors.initials: SA
authors.lastname: Avdiushko
authors.forename: Hua
authors.initials: H
authors.lastname: Zhu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kryscio
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006564:Herpesviridae / Q000145:classification* / Q000302:isolation & purification*; D006566:Herpesviridae Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008297:Male; D009055:Mouth / Q000473:pathology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012463:Saliva / Q000821:virology*; D019562:Viral Load
chemical_list: D004279:DNA, Viral