Incidence Of HSV,VZV And EBV In Saliva Of Human Immunodeficiency Virus Type 1-infected Patients And Healthy Controls In Yunnan, China

[Objective] Human herpesviruses (HHVs) is a common HIV-related opportunistic infection virus,which is a major cause of death in HIV-infected patients. Saliva are likely determinants of risk for transmission. However, very little information on oral HHV opportunistic infections and its relationship with oral lesions,HIV infection course,immune status and HAART in Mainlan China is available. This study focused on herpes simplex virus type 1 and 2 (HSV-1 and HSV-2), Vericella Zoster virus (VZV), Epstein Barr virus (EBV) that commonly occur in the oral cavity and cause significant diseases in HIV-infected persons. Its aim was to determine the prevalence of these four HHVs in the saliva of HIV-infected persons. Correlates between the presence of the four HHVs and the degree of cellular immunosuppression, oral lesions, and demographic factors in a group of HIV-positive patients were assessed. It would be to provide a basis for future studies that can investigate if salivary levels of HHVs are useful for monitoring disease states and risk for progression of HHV-related diseases.[Methods] Polymerase chain reaction(PCR) or nested PCR was used to investigate the prevalence, risk and correlations of salivary HSV-1,HSV-2,VZV and EBV from 245 HIV-seropositive individuals from Kunming Third Hospital AIDS Center and 30 healthy control subjects in this study.100 of the HIV-seropositive patients were taking HAART. All samples were collected in 2008-2010. The oral lesions, CD4+T lymphocyte count and more clinical index were also collected. The data was analyzed by the use of SPSS Statistical software version 18.0.[Results] According to analysis of the results:(1) Of the study participants, male: female was 1.99:1 in HIV-infected patients,1.73:1 in control group. the majority(95.1%) of the patients being in 20 to 60 years. the majority of the transmission was through injection drug use (43.7%),followed by sexual transmission with 39.6%; mode of transmission through transfusion was 0.4%; and unknown transmission was 16.3%. (2) In the HIV-seropositive group, the most prevalent viral DNA was EBV 82.0%(201/245), followed by HSV-130.0%(71/245), VZV 4.1%(10/245), and HSV-2 3.3%(8/245). Detection rates in the HIV-seronegative group were as follows:EBV,36.7%; HSV-1,13.3%;HSV-2 DNA and VZV were not detected in this group. This four HHVs were significantly more prevalent in the salivas of HIV-seropositive persons than in those of the controls (P< 0.01). (3) Although patients who taking HAART had high CD4 cell count level, the detection rates in saliva for HSV-1,HSV-2,VZV and EBV DNA were more prevalent in HIV-infected persons with HAART than control subjects, but with no observed difference between the HIV-positive group with HAART and HIV-positive group without HAART (P>0.05). (4) Positive for HSV-1 DNA in Herpetic stomatitis is 90.9%, Positive for VZV DNA in Herpes Zoster is 57.1%, EBV was detected in high rate of 90.2% for patients with oral hairy leukoplakia. (5) HSV-1 positive rate in HIV-positive with oral lesions group was highter than HIV-positive without oral lesions group. HSV-2, VZV, EBV positive rate were no observed difference between them. (6) When CD4 T lymphocyte count less than 200/μl, the saliva of patients more easier detected HSV-1, VZV, EBV. CD4T lymphocyte count and HSV-1 and EBV-exist have significantly negative correlated(P=0.0001). The group of CD4 T lymphocyte count below 200/μl simultaneously were detected HSV-1 and EBV in saliva higher than CD4 T lymphocyte count over 400/μl. CD4 T lymphocyte count more lower, HHVs detection rate more higher, a negative correlation between CD4 T lymphatic and detection rate of HHVs. [Conclusion] The observations reported herein suggest that the presence of the four HHVs determined by the PCR technique in saliva is a frequent event in HIV-infected individuals from Yunnan China, even in the presence of HAART therapy, HAART does not appear to diminish the risk for asymptomatic HHVs shedding. EBV was the virus most commonly found, followed by HSV-1, VZV and HSV-2 were detected at low prevalence. This study represents the first report of the prevalence of multiple salivary HHVs in HIV-seropositive patients and HIV-seronegative individuals from Yunnan China and it has contributed baseline data and provided insights in viral OI and HIV co-infection in China. This would undoubtedly serve as a basis for further studies on this topic.