Journal of Dental Research, Vol 80, 414-420, Copyright © 2001 by International & American Associations for Dental Research Online Journals

ARTICLES

Hyper-excretion of human immunodeficiency virus type 1 RNA in saliva

D. C. Shugars, L. L. Patton, S. A. Freel, L. R. Gray, R. T. Vollmer, J. J. Eron Jr and S. A. Fiscus
School of Dentistry, University of North Carolina at Chapel Hill, 27599-7450, USA. diane_shugars@dentistry.unc.edu

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 hyperexcretion 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.

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