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Hyper-excretion of Human Immunodeficiency Virus Type 1 RNA in Saliva

School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA, School of Medicine, CB 7450, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA, diane_shugars{at}dentistry.unc.edu

L.L. Patton

School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA

S.A. Freel

School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA

L.R. Gray

School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA

R.T. Vollmer

Durham Veterans Administration and Duke Medical Centers, Durham, NC, USA

J.J. Eron, JR

School of Medicine, CB 7450, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA

S.A. Fiscus

School of Medicine, CB 7450, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA

Anatomical compartments (e.g., the reproductive tract) are reservoirs of human immunodeficiency virus type-1 (HIV-1) and potential sites of residual infection in patients receiving anti-retroviral therapy (ART). Viral hyper-excretion relative to blood is a hallmark of reservoirs. To determine whether hyper-excretion can occur in the oral cavity, we compared viral loads in blood plasma and saliva of 67 adults. Salivary viral hyper-excretion was defined as a four-fold or higher viral load in saliva than in plasma. HIV-1 RNA was detected in 79% of plasma samples, in 44% of unfiltered saliva samples, in 16% of filtered saliva samples, and in 59% of saliva-derived cell pellets. Compared with non-hyper-excretors (n = 62), hyper-excretors (n = 5) had elevated levels of viral RNA in unfiltered saliva and saliva-derived cells, HIV-associated periodontal disease, gingival inflammation, and no combination ART. Morphological characterization of cell pellets identified lymphocytes as a likely HIV-1 source. These collective findings are consistent with an oral HIV-1 reservoir in selected individuals.

Key Words: Human immunodeficiency virus • saliva • blood • viral load • anti-retroviral therapy

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Journal of Dental Research, Vol. 80, No. 2, 414-420 (2001)
DOI: 10.1177/00220345010800020301


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