Clinical Oral Condition Analysis and the Influence of Highly Active Antiretroviral Therapy on Human Salivary Microbial Community Diversity in HIV-Infected/AIDS Patients

Abstract

The purpose of this study was to assess the clinical oral status and investigate the effect of highly active antiretroviral therapy (HAART) on oral flora diversity in human immunodeficiency virus (HIV)-infected/acquired immune deficiency syndrome (AIDS) patients. We first recorded and analyzed the demographic indicators of 108 HIV-infected patients and assessed their periodontal health, dental health and oral lesion status by oral examination. Besides, we compared the changes in salivary microbial communities of healthy controls, before and after treatment of HAART-processed AIDS patients by Roche 454 sequencing and RT-qPCR. In HIV-infected/AIDS patients, age, sex, marital status, income level, smoking and oral health behaviors had an effect on periodontal clinical indicators; age and marital status were correlated with dental clinical indicators; most of them were accompanied by oral manifestations, mainly including candidiasis albicans, salivary gland disease, AIDS-associated periodontitis, and oral ulcers. Besides, a total of 487 species were detected in the saliva of AIDS patients. The microbial communities of HAART-unprocessed AIDS patients significantly differed from those processed patients, with 112 unique microbial species. More importantly, a large number of conditioned pathogens were also detected in the saliva samples of AIDS patients, which may be associated with opportunistic infections. Therefore, HAART might have a crucial role in salivary microecological balance in AIDS patients. And these patients should pay attention to the maintenance of oral health, and the early initiation of HAART may be important for the development of oral lesions.

Adherence to antiretroviral therapy, CD4 count, viral load and opportunistic infections in people with HIV/AIDS: a cross-sectional study

“…Non-adherent ART for a long time results in the patient's immunosuppressed condition which results in more frequent or more severe OI, and can be the cause of serious morbidity and even mortality (Duff, 2019). Preventing OI can be initiated by vaccination, such as meningococcal infection, pneumococcal infection, hepatitis A and B, influenza and varicella, but it is not the most effective solution (Cao et al, 2022). Other major OI requires prophylactic antibiotics or antiviral medications (Sangeda et al, 2018), so it is very important for them to increase ART.…”

Human immunodeficiency virus and oral microbiota: mutual influence on the establishment of a viral gingival reservoir in individuals under antiretroviral therapy

“…Regarding the impact of HIV-infection in the bacterial diversity of oral microbiota, conflicting results are found in the literature: while a few studies showed no significant difference between PLWH and controls ( Mukherjee et al., 2014 ; Goldberg et al., 2015 ; Gonçalves et al., 2019 ; Meng et al., 2023 ), other studies found significant differences between both groups ( Gonçalves et al., 2007 ; Silva-Boghossian et al., 2008 ; Iwai et al., 2012 ; Hegde et al., 2014 ; Li et al., 2014 ; Kistler et al., 2015 ; Noguera-Julian et al., 2017 ; Presti et al., 2018 ; Griffen et al., 2019 ; Lewy et al., 2019 ; Coker et al., 2020 ; Yang et al., 2020 ; Perez Rosero et al., 2021 ; Guo et al., 2021b ; Cao et al., 2022 ; Ramos Peña et al., 2022 ; Beall et al., 2023 ; Kuhn et al., 2023 ).…”

“…The reported results regarding bacterial taxonomy in PLWH differed according to the type of samples, being saliva, biofilm, oral rinses and mucosal swabs, the most common methods used to assess the oral microbiota. The main taxonomical differences found in PLWH have been related to increased abundance of genera such as Campylobacter , Granulicatella, Neisseria , Fusobacterium , and Selenomonas ( Li et al., 2014 , 2021 ; Guo et al., 2021b ; Cao et al., 2022 ), and decreased abundance of Actinomyces, Lactobacillus, Peptostreptococcus and Treponema ( Gonçalves et al., 2007 ; Silva-Boghossian et al., 2008 ; Annavajhala et al., 2020 ; Ramos Peña et al., 2022 ). On the other hand, an association with increased abundance of Lactobacillus , Lautropia and Bacteroides has been reported in controls ( Li et al., 2014 ; Imahashi et al., 2021 ; Li et al., 2021 ) ( Table 2 and Figure 1 ).…”

“…In HIV-infected untreated patients, mean alpha diversity is more variable between individuals, with high abundance of Bacteroidota , Bacillota and Proteobacteriota . After 24 weeks of effective ART, the dominant phyla remain similar to baseline, without differences in beta or alpha diversity; however, bacterial communities became more similar between individuals, with enrichment of health-related genera such as Fusobacterium , Campylobacter , Prevotella , Capnocytophaga , Selenomonas , Actinomyces , Granulicatella and Atopobium , and decrease of pathogenic genera such as Porphyromonas and Aggregatibacter ( Yang et al., 2020 ; Li et al., 2021 ; Cao et al., 2022 ). The bacterial communities within each individual present changes before and after ART, suggesting high person-to-person variability on salivary bacterial microbiota between baseline and 24 weeks after ART ( Presti et al., 2018 ; Cao et al., 2022 ) ( Figure 1 ).…”

Men with HIV Have Increased Alveolar Bone Loss

“…Prior studies among PLWH have found an association between increased severity of periodontitis and increased prevalence of P. gingivalis, elevated C-reactive protein (CRP) levels, and higher proportions of circulating CD8 + cells [10]. Other studies suggest that ART may have an important role in balancing the salivary microecological oral environment [11]. Consequently, this study seeks to assess alveolar bone loss, gingival crevicular uid cytokine markers, and periodontal disease activity in men.…”