title: Highly-active antiretroviral therapy and oral opportunistic microorganisms in HIV-positive individuals of Thailand.
abstract: OBJECTIVE
  Oral mucosal lesions and opportunistic microorganisms in HIV-positive Thais treated with highly-active antiretroviral therapy (HAART) for more than 5 years were investigated.
  
  
  METHODS
  A total of 221 HIV-infected patients, comprising 148 HIV patients undergoing HAART for more than 5 years, 20 non-HAART HIV patients, 53 vertically-transmitted (VT) HAART HIV patients, and 30 HIV-negative controls, were examined for CD4+ counts, viral load, saliva secretion rate, and oral mucosal lesions. Samples from the tongue, gingival crevices, and mucosal lesions when present were cultured for the amounts of Candida, staphylococci, enterococci, and aerobic Gram-negative bacilli.
  
  
  RESULTS
  HAART (including HIV-VT) maintained oral microbial homeostasis predominated by alpha-hemolytic streptococci similar to the non-HIV controls and with a low prevalence of mucosal lesions. The HAART group had a reduced saliva secretion rate. The frequency and load of opportunistic microorganisms in the HAART group were similar to the non-HAART group, which was significantly higher than the HIV-negative controls. Candida spp. was found significantly more frequently on the tongue in HIV-infected individuals with CD4+ counts <500 cells/mm(3).
  
  
  CONCLUSIONS
  Although we did not find lower levels of mucosal lesions among HAART compared to non-HAART individuals, HAART therapy could prolong the time before opportunistic oral pathogens overwhelm the commensal members of oral microbiota.
authors.affiliation: Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.|Infectious Diseases Clinic and Dental Hospital, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Pratanporn
authors.initials: P
authors.lastname: Arirachakaran
authors.affiliation: Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Yong
authors.initials: Y
authors.lastname: Poovorawan
authors.affiliation: Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Dahlén
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D009059:Mouth Diseases; D013785:Thailand; D019562:Viral Load
keywords: Candida; HIV; Staphylococcus aureus; aerobic Gram-negative bacilli; highly-active antiretroviral therapy