Oral shedding of herpesviruses in HIV-infected patients with varying degrees of immune status
Objective: Herpesvirus shedding in the oral cavity was analyzed to determine if presence in the oral compartment correlates with systemic changes in HIV-associated immune deficiency as measured by CD4+ cell counts, plasma HIV viral load and presence of AIDS-defining events.
Design: A5254 is a multicenter, cross-sectional, single-visit study to evaluate oral complications of HIV/AIDS and determine the association between clinical appearance, herpesvirus shedding, and immune status as ascertained by CD4+ cell count and HIV viral load. In total, 307 HIV-infected individuals were evaluated and throat wash collected.
Methods: Fisher's exact test and Kruskal–Wallis test were used to assess the association between presence of herpesviruses and the state of immunodeficiency as stratified by a combination of CD4+ cell count and HIV viral load. Relationship between pathogens and HIV viral load in plasma was modeled by logistic regression.
Results: The presence of cytomegalovirus (CMV) and herpes simplex virus-1 in throat wash was associated with decreased CD4+ cell counts. By contrast, Kaposi sarcoma-associated herpesvirus and Epstein–Barr virus were similarly detectable across all levels of CD4+ cell counts. One unit increase in log10 (HIV viral load) was associated with 1.31 times higher odds of detecting CMV in throat wash when controlling for oral candidiasis, CD4+ cell count, and sites (95% confidence interval 1.04–1.65, P = 0.02).
Conclusion: Oral CMV shedding was significantly higher in highly immunocompromised HIV+ participants. Our finding supports the recommendations to start antiretroviral therapy independent of CD4+ cell count as this may have the added benefit to lower the risk of herpesvirus transmission among persons infected with HIV and their partners.Publisher URL: http://journals.lww.com/aidsonline/Fulltext/2017/09240/Oral_shedding_of_herpesviruses_in_HIV_infected.5.aspx
DOI: 10.1097/QAD.0000000000001589
Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.
Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.