Presence of Epstein-Barr virus, cytomegalovirus and human papillomavirus in normal oral mucosa of HIV-infected and renal transplant patients.

OBJECTIVES

To determine the prevalence of EBV-DNA, CMV-DNA and HPV-DNA in oral healthy mucosa of HIV-infected and renal transplant patients. To associate the detection of viral genomes with laboratory parameters of immunodeficiency, gender, antiretroviral and immunosuppressive therapy.

DESIGN

A cross-sectional analysis of lingual and buccal cytobrushings from HIV-infected and renal transplant patients.

SUBJECTS AND METHODS

Lingual and buccal cytobrushings were obtained from clinically normal oral mucosa of 57 HIV+, 40 renal transplant patients and 30 healthy uninfected controls, all matched for age at baseline of examination. Presence of EBV-, CMV- and HPV-DNA was assessed by polymerase chain reaction (PCR). We evaluated their association, in HIV+ subjects, with gender, CD4+ cell count, HIV-RNA load, and antiretroviral therapy; and in renal transplant patients, with gender, CD4/CD8 ratio, and immunosuppressive therapy. Data were managed and analysed by Epi-Info 6.0.

RESULTS

EBV-DNA was detected in 42.1% of HIV+ (24/57), in 65.0% of transplant patients (26/40), and in 16.6% of controls (5/30) (P = 0.03 and P = 0.0001, respectively). Furthermore, male gender in HIV+ group was found to be significantly associated with the presence of EBV-DNA (P = 0.02) vs females, after adjusting for CD4+ cell count and HIV-RNA load. CMV- and HPV-DNA were detected in 3.5% and 7.0% of HIV+, and in none and 20.0% of transplant patients, respectively. No relationship was found between the epithelial detection of these two viruses and any parameter evaluated.

CONCLUSIONS

EBV genome was significantly detected in clinically normal oral mucosa of renal transplant and HIV+ patients. A significant gender association was found among HIV+, suggesting that oral hairy leukoplakia (OHL) is more likely to occur in HIV+ men than women.