Low prevalence of varicella zoster virus and herpes simplex virus type 2 in saliva from human immunodeficiency virus-infected persons in the era of highly active antiretroviral therapy.
OBJECTIVE
Human herpesviruses, e.g., herpes simplex virus (HSV) type 1, Epstein-Barr virus, and cytomegalovirus, appear in saliva at greater frequency in persons infected with human immunodeficiency virus (HIV) than in healthy individuals. However, it is not known if varicella zoster virus (VZV) and HSV-2 appear simultaneously during HIV infection at greater frequency in saliva in this era of highly active antiretroviral therapy (HAART). The aim of this study was to investigate the prevalence and amounts of VZV and HSV-2 in the saliva of HIV-infected orally asymptomatic patients.


METHODS
Quantitative polymerase chain reaction was used to investigate the prevalence, quantity, risk, and correlations of salivary VZV and HSV-2 from 59 HIV-seropositive individuals and 53 healthy control subjects in a case-control cross-sectional study. Seventy-eight percent of the HIV-seropositive patients (46 out of 59) were taking HAART.


RESULTS
VZV DNA was detected in the saliva of 5.1% (3 out of 59) of the HIV-positive group and in only 1 healthy control 1.9% (1 out of 53; P = .62). The amount of VZV DNA in the expressors was low, generally <1,100 copies/mL, with no observed difference between the HIV-positive group and the control subjects (P = 1.0). HSV-2 DNA was not detected in either group. In the HIV-infected group, VZV shedding occurred in those on HAART, but was not associated with oral lesions, specific CD4(+) or CD8(+) T-cell levels, or demographic factors.


CONCLUSIONS
Varicella zoster virus was detected at low prevalence in the saliva of HIV-infected persons, whereas HSV-2 was not detected in the saliva of this cohort. HAART does not appear to diminish the risk for asymptomatic VZV shedding.
Wang
Chunmei C
CC
Department of Oral Health Practice, University of Kentucky College of Medicine and College of Dentistry, Lexington, Kentucky 40536-0297, USA. george.sandor@utoronto.ca
Yepes
Luis C
LC
Danaher
Robert J
RJ
Berger
Joseph R
JR
Mootoor
Yunanan
Y
Kryscio
Richard J
RJ
Miller
Craig S
CS
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000821:virology*; D018709:Statistics, Nonparametric; D019562:Viral Load / Q000276:immunology; D017201:Virus Shedding / Q000276:immunology*; D055815:Young Adult
D004279:DNA, Viral