Oral human β-defensin 2 in HIV-infected subjects with long-term use of antiretroviral therapy.
BACKGROUND
The objectives of this study were to determine (i) oral hBD2 expression in HIV-infected subjects compared with non-HIV controls, (ii) the expression of oral hBD2 in HIV-infected subjects with antiretroviral therapy (ART) compared with those without ART, and (iii) factors associated with the expression of oral hBD2.


METHODS
Oral examination and punched biopsy on buccal mucosa were performed in HIV-infected subjects with and without ART, and non-HIV individuals. The expression of hBD2 mRNA was determined by quantitative real-time PCR. Saliva samples of both un-stimulated and stimulated saliva were collected and analyzed for hBD2 levels using ELISA. Student's t-test and nonparametric multi-way ANOVA test were used for comparison of measurements between or among groups.


RESULTS
One hundred and fifty-seven HIV-infected subjects were enrolled: 99 on ART (age range, 23-57 years; mean 39 years), 58 not on ART (age range, 20-59 years; mean 34 years), and 50 non-HIV controls (age range, 19-59 years; mean 36 years). The most common ART regimen was two nucleoside reverse transcriptase inhibitors + one non-nucleoside reverse transcriptase inhibitor. Salivary levels of hBD2 were significantly increased in HIV infection (P < 0.001). The levels of hBD2 in stimulated saliva were also found to be significantly different between HIV-infected subjects who were and were not on ART (P < 0.001). No significant difference was observed with the expression of hBD2 mRNA.


CONCLUSIONS
Oral innate immunity is affected by HIV infection and use of ART. Salivary hBD2 levels may be the useful biomarkers to monitor those on long-term ART who are at risk of developing oral infections and malignant transformation.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. wipawee.ni@psu.ac.th
Wipawee
W
Nittayananta
Marisa
M
Kemapunmanus
Korntip
K
Amornthatree
Sineepat
S
Talungchit
Hutcha
H
Sriplung
D000328:Adult; D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023181:Antimicrobial Cationic Peptides / Q000096:biosynthesis*; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D007113:Immunity, Innate; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism; D012044:Regression Analysis; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012471:Salivary Proteins and Peptides / Q000032:analysis; D018709:Statistics, Nonparametric; D019562:Viral Load; D055815:Young Adult; D023083:beta-Defensins / Q000096:biosynthesis*
D019380:Anti-HIV Agents; D023181:Antimicrobial Cationic Peptides; C106641:DEFB4A protein, human; D018894:Reverse Transcriptase Inhibitors; D012471:Salivary Proteins and Peptides; D023083:beta-Defensins