Prevalence of periodontal pathogegens and Epstein-Barr virus, Cytomegalovirus and herpes simplex virus in saliva, periodontal pockets and blood of HIV positive subjects with periodontal disease

Abstract

The host infected with HIV may present several local and systemic immunological changes that probably facilitate the incidence of a variety of diseases including periodontal diseases (Lamster IB et al, 1998; Lucht E et al, 1991; Winkler JR et al 1988). Although the relationship between periodontal health and HIV infection has been extensively studied, many aspects are still poorly understood. (Robinson PG et al 2002). Thus, the presence of plaque and specific periodontopathogens seem to play a secondary role in the development of periodontal diseases in these patients. Studies examining the subgingival microbiota in sites with periodontal disease have shown similarity between HIV-positive and negative, although some studies showed differences in the proportions of certain species. (Murray et al 1991). Among the bacteria found in systemically compromised individuals the most cited are Porphyromonas gingivalis (Pg), Prevotella intermedia(Pi), Fusobacterium nucleatum(Fn), Aggregatibacter actinomycetemcomitans (Aa),Eikenella corrodens and Campylobacter rectus.(Chattin BR et al 1999, Murray PA et al 1987; Murray PA et al 1988; Murray PA et al 1989; Zambon JJ et al 1990. Recent studies have revealed the involvement of the herpes family viruses in the etiopathogenesis of periodontal disease. Although the role of herpesvirus in the etiopathogenesis of periodontal diseases in these individuals has not been determined, the presence of high levels of virus in periodontal tissues may favor the growth of periodontopathogens as well as of opportunistic organisms by suppressing the defense mechanisms of the host ( SHIRAI A et al 1992). In addition, it has been demonstrated that coinfection of different herpesvirus in the subgingival microbiota may increase the levels of periodontopathogens in sites with periodontal disease. The types of virus most frequently associated with periodontal disease are the Epstein Barr 1, cytomegalovirus (HCMV), and to a lesser extent the herpes simplex virus (HSV) and human herpes virus (HHV-6, HHV-7 and HHV-8 ). (Contreras, Slots, 1996).While further studies are needed to elucidate the role of herpesvirus in the etiology of periodontal disease in positive HIV and the relantionship with bacterials ,and there are no studies comparing the presence of EBV virus, HSV and CMV and pathogens in HIV-positive individuals with periodontal disease. According to Correa et al in 1994 immunocompromised individuals has shown a greater association with these viruses and immunosuppression induced by HIV is known to facilitate the reactivation of these microorganisms (FAUCCI 1993). This study aims to determine the prevalence and association between the following bacteria (Pg, Pi, Aa, Tanerella forsythia) and virus (EBV, CMV and HSV) in the periodontal pocket, saliva and peripheral blood of HIV-positive patients. Saliva, peripheral blood and periodontal pocket biofilm samples of 30 HIV-positive patients with Chronic Periodontitis, 30 HIV-positive patients with gingivitis, 30 systemically healthy individuals with Chronic Periodontitis and 30 individuals systemically and periodontally healthy. Medical history and clinical evaluation of the individuals will be recorded from following parameters: bleeding on probing, pocket probing depth and clinical attachment level at 6 sites/tooth with the aid of a periodontal probe. Sterile paper points will be used to collect biofilm samples from periodontal pockets with the aim of detecting the DNA of proposed virus and bacteria. Non-stimulated saliva will be collected with universal collectors. The collection of peripheral blood will be obtained by venipuncture. Results will be analyzed using PCR and adequate statistical methods. (AU)