Epstein-Barr virus oral shedding and viremia and their association with oral hairy leukoplakia in HIV+ individuals.

OBJECTIVE: To assess the oral shedding and viremia of Epstein-Barr virus (EBV) in HIV-positive patients and their relationship with oral hairy leukoplakia (OHL). METHODOLOGY: A total of 94 HIV-positive patients were included in the study, in which blood and saliva samples were collected for EBV quantification. Data on gender, age, time of HIV seropositivity, combined antiretroviral therapy (cART), CD4+ T-cell counts, and HIV viral load were collected. OHL diagnosis was based on histopathological examination and EBV in situ hybridization. RESULTS: The EBV load in the 94 HIV-positive patients was higher in saliva than in blood (2.4 and 1.6, respectively), and there was a positive correlation between EBV oral shedding and viremia (p = 0.001). Twenty (21.27%) patients had OHL and also a higher EBV load in saliva (mean log10  = 3.11) compared to those who had no OHL (p = 0.045). Presence of OHL was only associated with age (p = 0.030). CONCLUSION: In HIV-positive patients, the presence of OHL was associated with EBV oral shedding but not with viremia, regardless of the amount of circulating CD4+ T cells.

Comorbidades e manifestações bucais em pacientes idosos HIV positivos / Comorbidities and bucal manifestations in HIV-positive older patients

A epidemia do HIV/AIDS vive o final de sua terceira década seguida por importantes avanços terapêuticos e uma considerável expectativa de vida dos pacientes infectados. Diversas comorbidades têm sido frequentemente observadas, relacionadas com o próprio envelhecimento e/ou com o uso de terapia antiretroviral por tempo prolongado. As manifestações bucais oportunistas tornam-se mais raras, e outras alterações estão se tornando mais prevalentes e merecem atenção do cirurgião-dentista. O objetivo deste trabalho foi verificar a prevalência de comorbidades e de manifestações bucais em pacientes idosos portadores de HIV atendidos no CAPE-FOUSP, e analisa-las de acordo com dados demográficos e estado imunológico dos pacientes. Foram avaliados prontuários de 61 pacientes, de onde foram coletados dados demográficos e relativos à infecção pelo HIV. Todos os pacientes exibiam alguma comorbidade. Quarenta e um (70,5%) pacientes apresentaram ao menos uma manifestação bucal relacionada ao HIV, sendo as mais freqüentes a candidíase oral e a xerostomia. É importante que o cirurgião-dentista conheça o perfil do paciente HIV positivo idoso, as condições bucais mais observadas e as comorbidades mais frequentes, especialmente as que apresentem repercussões no manejo odontológico.

HIV/AIDS epidemic lives the end of its third decade followed by important advances in the therapy and life expectancy of the infect patients, with a growing number of HIV-positive older patients. Some comorbidities are becoming more common, related with aging and the long-term use of some antiretroviral medications. Some buccal manifestations are still considered important markers of HIV progression. Although, some lesions are becoming more frequent. All of them deserve attention by the dentist. Based on this, this article purpose is to verify the prevalence of comorbidities and HIV-related buccal manifestations on older patients attended on HIV-positive patients of Special Care Dentistry Center of Sao Paulo University (CAPE-FOUSP), and analyze them according to demographic data and immunologic status of the patients. Sixty-one patients were evaluated retrospectively and information about HIV infection and demographic data were collected. All patients comorbidities. Forty-three patients (75,5%) exhibited at least one buccal manifestation and the frequent are oral candidiasis and xerostomia. Is important for the oral health provider know the current profile of HIV-positive older patient, witch includes associated oral conditions and the most frequent comorbidities, especially those that demand changes in the dental management.