Oral shedding of herpesviruses in HIV-infected patients with varying degrees of immune status

被引:15
作者
Dittmer, Dirk P. [1 ,2 ]
Tamburro, Kristen [1 ,2 ]
Chen, Huichao [3 ]
Lee, Anthony [3 ]
Sanders, Marcia K. [2 ]
Wade, Tischan A. [2 ]
Napravnik, Sonia [1 ]
Webster-Cyriaque, Jennifer [1 ,2 ,4 ]
Ghannoum, Mahmoud [5 ]
Shiboski, Caroline H. [6 ]
Aberg, Judith A. [7 ]
机构
[1] Univ North Carolina Chapel Hill, UNC Sch Med, Dept Microbiol & Immunol, Chapel Hill, NC USA
[2] Univ North Carolina Chapel Hill, UNC Sch Med, Ctr AIDS Res, UNC Lineberger Comprehens Canc Ctr, Chapel Hill, NC USA
[3] Harvard TH Chan Sch Publ Hlth, Ctr Biostat AIDS Res, Boston, MA USA
[4] Univ North Carolina Chapel Hill, UNC Sch Dent, Chapel Hill, NC USA
[5] Case Western Reserve Univ, Univ Hosp Cleveland, Med Ctr, Ctr Med Mycol, Cleveland, OH 44106 USA
[6] Univ Calif San Francisco, UCSF Sch Dent, Dept Orofacial Sci, San Francisco, CA 94143 USA
[7] Icahn Sch Med Mt Sinai, Dept Med, Div Infect Dis, New York, NY 10029 USA
关键词
AIDS; clinical trial; cytomegalovirus; Epstein-Barr virus; herpesviruses; HIV; Kaposi sarcoma; Kaposi sarcoma-associated herpesvirus; oral hairy leukoplakia; SARCOMA-ASSOCIATED HERPESVIRUS; EPSTEIN-BARR-VIRUS; KAPOSIS-SARCOMA; HAIRY LEUKOPLAKIA; RISK-FACTORS; HUMAN-HERPESVIRUS-8; SALIVA; DNA; INDIVIDUALS; REPLICATION;
D O I
10.1097/QAD.0000000000001589
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
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 log(10) (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. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
引用
收藏
页码:2077 / 2084
页数:8
相关论文
共 50 条
[1]   Kaposi's sarcoma herpesvirus-like DNA sequences in the saliva of individuals infected with human immunodeficiency virus [J].
Boldogh, I ;
Szaniszlo, P ;
Bresnahan, WA ;
Flaitz, CM ;
Nichols, MC ;
Albrecht, T .
CLINICAL INFECTIOUS DISEASES, 1996, 23 (02) :406-407
[2]   Valganciclovir for suppression of human herpesvirus-8 replication: A randomized, double-blind, placebo-controlled, crossover trial [J].
Casper, Corey ;
Krantz, Elizabeth M. ;
Corey, Lawrence ;
Kuntz, Steven R. ;
Wang, Jie ;
Selke, Stacy ;
Hamilton, Shannon ;
Huang, Meei-Li ;
Wald, Anna .
JOURNAL OF INFECTIOUS DISEASES, 2008, 198 (01) :23-30
[3]   Frequent and asymptomatic oropharyngeal shedding of human herpesvirus 8 among immunocompetent men [J].
Casper, Corey ;
Krantz, Elizabeth ;
Selke, Stacy ;
Kuntz, Steven R. ;
Wang, Jie ;
Huang, Meei-Li ;
Pauk, John S. ;
Corey, Lawrence ;
Wald, Anna .
JOURNAL OF INFECTIOUS DISEASES, 2007, 195 (01) :30-36
[4]  
Centers for Disease Control (CDC), 1985, MMWR Morb Mortal Wkly Rep, V34, P549
[5]   Prevention of HIV-1 Infection with Early Antiretroviral Therapy [J].
Cohen, Myron S. ;
Chen, Ying Q. ;
McCauley, Marybeth ;
Gamble, Theresa ;
Hosseinipour, Mina C. ;
Kumarasamy, Nagalingeswaran ;
Hakim, James G. ;
Kumwenda, Johnstone ;
Grinsztejn, Beatriz ;
Pilotto, Jose H. S. ;
Godbole, Sheela V. ;
Mehendale, Sanjay ;
Chariyalertsak, Suwat ;
Santos, Breno R. ;
Mayer, Kenneth H. ;
Hoffman, Irving F. ;
Eshleman, Susan H. ;
Piwowar-Manning, Estelle ;
Wang, Lei ;
Makhema, Joseph ;
Mills, Lisa A. ;
de Bruyn, Guy ;
Sanne, Ian ;
Eron, Joseph ;
Gallant, Joel ;
Havlir, Diane ;
Swindells, Susan ;
Ribaudo, Heather ;
Elharrar, Vanessa ;
Burns, David ;
Taha, Taha E. ;
Nielsen-Saines, Karin ;
Celentano, David ;
Essex, Max ;
Fleming, Thomas R. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (06) :493-505
[6]   Kaposi sarcoma-associated herpesvirus: immunobiology, oncogenesis, and therapy [J].
Dittmer, Dirk P. ;
Damania, Blossom .
JOURNAL OF CLINICAL INVESTIGATION, 2016, 126 (09) :3165-3175
[7]  
EPSTEIN JB, 1989, LANCET, V2, P1100
[8]   Salivary cytomegalovirus (CMV) shedding, glycoprotein B genotype distribution, and CMV disease in human immunodeficiency virus-seropositive patients [J].
Fidouh-Houhou, N ;
Duval, X ;
Bissuel, F ;
Bourbonneux, V ;
Flandre, P ;
Ecobichon, JL ;
Jordn, MC ;
Vildé, JL ;
Brun-Vézinet, F ;
Leport, C .
CLINICAL INFECTIOUS DISEASES, 2001, 33 (08) :1406-1411
[9]   Prospective Characterization of the Risk Factors for Transmission and Symptoms of Primary Human Herpesvirus Infections Among Ugandan Infants [J].
Gantt, Soren ;
Orem, Jackson ;
Krantz, Elizabeth M. ;
Morrow, Rhoda Ashley ;
Selke, Stacy ;
Huang, Meei-Li ;
Schiffer, Joshua T. ;
Jerome, Keith R. ;
Nakaganda, Annet ;
Wald, Anna ;
Casper, Corey ;
Corey, Lawrence .
JOURNAL OF INFECTIOUS DISEASES, 2016, 214 (01) :36-44
[10]   Seroconversion to antibodies against Kaposi's sarcoma-associated herpesvirus-related latent nuclear antigens before the development of Kaposi's sarcoma [J].
Gao, SJ ;
Kingsley, L ;
Hoover, DR ;
Spira, TJ ;
Rinaldo, CR ;
Saah, A ;
Phair, J ;
Detels, R ;
Parry, P ;
Chang, Y ;
Moore, PS .
NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (04) :233-241