| Objectives:The objectives of this study were 1) to observe oral Candida carriages, prevalence of oral candidiasis and the expressions of salivary hBD-2,-3 in HIV/AIDS patitents during the first year of HAART, and to investigate the possible relationship among them; 2) to explore the influence of HAART on oral Candida status and salivary hBD-2,-3 expressions.Methods:A total of 90 HIV/AIDS patients who were ready to recieve HAART were included in the study. The HIV/AIDS patients were examined at the bastline,3rd,6th,12th month of HAART,and completed one year of follow-up. Oral examinations for all the individuals were carried out and recorded in details. Peripheral blood samples were collected for measurement of CD4+ T cell counts by flow cytometry method; oral rinse samples were collected to quantify oral Candida carriages by plating on sabouraud dextrose agar to culture for 48 hour; the biotype of the Candida species were tested by Gram staining, forming experiment of chlamydospore,ChroMagar culture and 45 ℃ isolation test; Unstimulated whole saliva were collected to test the expression of salivary hBD-2,3 by ELISA. A prospective self-controlled study were carried to observe the dynamic changes of CD4+ T cell counts,oral Candida carriages and salivary hBD-2,3 expressions in HIV/AIDS patients during the first year of HAART. Thirty age-and gender-matched healthy individuals were enrolled in the study as control.Results:The CD4+ T cell counts in HIV/AIDS patients at the first year of HAART decreased significantly(P<0.001). CD4+ T cell counts of HIV/AIDS patients at the 12th month of HAART was still significantly inferior to that of healthy controls (t=7.209, P<0.001)The numbers of the patients who suffered from oral candidiasis showed a decreased trend. The oral Candida colony forming unit(CFU) varied in a broad range, however it significantly decreased during the first year of HAART(P< 0.001); the oral Candida carriages in healthy controls were significant inferior to that of HIV/AIDS patients at the baseline of HAART (t=0.345,P=0.035), no statistical significance was observed bewteen healthy controls and HIV/AIDS at the 12th month of HAART. The isolation rate of oral Candida specie were 76%, 80%,81%,63%, and no statistical significance was observed. Candida albicans(C.albicans) was the prevailing isolated oral Candida species in HIV/AIDS patients and healthy controls, and except for C.albicans, ten other species which including C.parapsilosis, C.tropicalis, C.glabrata, C.krusei, C.guilliermondii, C.dubliniensis, C.rugosa, C.lusitaniae, C.norvegensis, and C.kefyr were isolated in HIV/AIDS patients.The levels of salivary hBD-2 in HIV/AIDS patients decreased significantly (t=13.969, P<0.001). The level of salivary hBD-2 in healthy controls was significantly inferior to that of HIV/AIDS patients at the 12th month of HAART. A broad range of expression of salivary hBD-3 was observed. The levels of hBD-3 varied in a broad range, but it still decreased significantly, the expression of salivary hBD-3 in HIV/AIDS patients at the 12th month of HAART compared to that of healthy controls, no statistical significance was deteced between HIV/AIDS patients and healthy controls(P>0.05).Simple corelation analyse were carried out among CFU, salivary hBD-2,-3 and CD4+T cell counts.The data of CFU and salivary hBD-3 were swithed to logarithm form.Lg CFU were positive related to the expression of salivary hBD-2 in HIV/AIDS patients at the four visits during the first year of HAART. Besides, a negative relationship between LgCFU and CD4+ T cell counts was detected in HIV/AIDS patients at the baseline,3rd,6th month of HAART. the expressions of salivary hBD-2 were positive related to the expression of hBD-3 in HIV/AIDS patients at the 3rd,6th,12th month of HAART. A negative corelation was observed between the expression of salivary hBD-2 and CD4+ T cell counts in HIV/AIDS patients at the baseline of HAART.According to the results of simple corelation analyse, LgCFU were related to the expressions of salivary hBD-2 and CD4+ T cell counts in HIV/AIDS patients at the baseline,3rd and 6th month of HAART, so multiple factor analyse were carried out to further analyze the relationship among them. The results showed that Lg CFU were positive related to the expression of salivary hBD-2 in HIV/AIDS patients at baseline,3rd and 6th month of HAART, and LgCFU were negative related to CD4+ T cell counts at the baseline and 3rd month of HAART.Conclusion:In conclusion, the oral Candida carriages, prevelance of oral candidiasis of HIV/AIDS patients gradually decreased during the first year of HAART as the recovery of immunity.In addition, HAART might influented the expressions of salivary hBDs. Salivary hBD-2 were positive related to the oral Candida carriages,which indicated that hBD2 could be highly induced by oral Candida species. |
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