Salivary IgA to cariogenic bacteria in HIV‐positive children and its correlation with caries prevalence and levels of cariogenic microorganisms

Abstract

The interrelationship of HIV infection, dental caries and mucosal immune responses remains controversial. In our study population of 40 HIV-infected and 40 healthy control children (ages 2-5 years) there was a significantly higher prevalence of dental caries in HIV-infected children (P<0.05). The extent of caries correlated with the severity of HIV disease. To determine whether the immunosuppression that ensues after HIV infection could contribute to the increased caries prevalence, the concentrations of total IgA and IgA specific to cariogenic bacteria (Streptococcus mutans, Streptococcus sobrinus and Lactobacillus acidophilus) were determined in whole saliva by enzyme-linked immunosorbent assay. Levels of the same bacteria were also quantified in saliva using checkerboard DNA-DNA hybridization. A significantly increased level of total salivary IgA was found in the HIV-positive population (P < 0.05), but there were comparable titers of specific IgA to cariogenic bacteria in HIV-positive and healthy controls. The microbiological assessment also demonstrated similar levels of cariogenic microorganisms in both groups. We conclude that HIV-positive children appear to maintain the capacity to mount a mucosal immune response to cariogenic microorganisms, at least until late stages of disease.

Levels of salivary IgA antibodies to Candida spp. in HIV-infected adult patients: A systematic review

“…However, as infection worsens, IgA concentration tends to decrease in AIDS patients. Such a fact is corroborated by Castro et al, 32 who observed that a group of more severely immunosuppressed patients had a low concentration of antibodies specific to cariogenic microorganisms. However, Wozniak et al 17 found no difference in the IgA concentration between patients presenting different levels of immunosuppression.…”

Efficacy of an Oral Health-Promoting Program in Human Immunodeficiency Virus-Infected Children: A 7-year Longitudinal Study

“…These results, however, were not observed in the present study as the difference between active and inactive caries in our sample was not found to be statistically significant. On the other hand, Hicks et al (2000) and Castro et al (2004) have observed that children with low levels of CD4 had higher defs index. In the present study, the number of severely immunosuppressed patients was small, thus demonstrating that most children were immunologically healthy as their mean CD4 count was relatively high (19.85%).…”

“…local and systemic immune-deficiency) regarding HIV infection are involved (Madigan et al, 1996;Valdez et al, 1994;Castro et al, 2004).…”

“…Some of these factors can be controlled through oral health education. Of course, this does not apply to systemic conditions such as low immune response (Castro et al, 2004) or carbohydraterich diet. Considering all these factors, we believe that clinical exams and regular fluoride applications, as well as other interventions for promoting oral health, can effectively control the onset and progression of caries in HIV-infected children.…”

“…In addition, HIV-infected children show greater immunological impairment and thus are more likely to have higher caries activity (Castro et al, 2004). Several factors may be involved, such as carbohydrate-rich diet for calorie/protein reposition, high intake of sugarcontaining compounds (Madigan et al, 1996;Maguire et al, 1996), decreased salivary flow (Ribeiro et al, 1998), low immune response to cariogenic bacteria (Madigan et al, 1996), inadequate oral hygiene and decreased salivary antibodies (Castro et al, 2004).…”