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Tugizov SM. Molecular Pathogenesis of Human Immunodeficiency Virus-Associated Disease of Oropharyngeal Mucosal Epithelium. Biomedicines 2023; 11:1444. [PMID: 37239115 PMCID: PMC10216750 DOI: 10.3390/biomedicines11051444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
The oropharyngeal mucosal epithelia have a polarized organization, which is critical for maintaining a highly efficient barrier as well as innate immune functions. In human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) disease, the barrier and innate immune functions of the oral mucosa are impaired via a number of mechanisms. The goal of this review was to discuss the molecular mechanisms of HIV/AIDS-associated changes in the oropharyngeal mucosa and their role in promoting HIV transmission and disease pathogenesis, notably the development of opportunistic infections, including human cytomegalovirus, herpes simplex virus, and Epstein-Barr virus. In addition, the significance of adult and newborn/infant oral mucosa in HIV resistance and transmission was analyzed. HIV/AIDS-associated changes in the oropharyngeal mucosal epithelium and their role in promoting human papillomavirus-positive and negative neoplastic malignancy are also discussed.
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Affiliation(s)
- Sharof M Tugizov
- Department of Medicine, School of Medicine, University of California, San Francisco, CA 94143, USA
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Pereira LMS, Dos Santos França E, Costa IB, Lima IT, Freire ABC, de Paula Ramos FL, Monteiro TAF, Macedo O, Sousa RCM, Freitas FB, Costa IB, Vallinoto ACR. Epidemiological risk factors associated with primary infection by Epstein-Barr virus in HIV-1-positive subjects in the Brazilian Amazon region. Sci Rep 2021; 11:18476. [PMID: 34531433 PMCID: PMC8446016 DOI: 10.1038/s41598-021-97707-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.
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Affiliation(s)
| | - Eliane Dos Santos França
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | - Iran Barros Costa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | - Igor Tenório Lima
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil
| | | | | | | | - Olinda Macedo
- Laboratory of Retroviruses, Evandro Chagas Institute, Virology Section, Ananindeua, Pará, Brazil
| | - Rita Catarina Medeiros Sousa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil.,School of Medicine, Federal University of Pará, Belém, Pará, Brazil
| | - Felipe Bonfim Freitas
- Laboratory of Retroviruses, Evandro Chagas Institute, Virology Section, Ananindeua, Pará, Brazil
| | - Igor Brasil Costa
- Epstein-Barr Virus Laboratory, Virology Section, Evandro Chagas Institute, Ananindeua, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil. .,Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil.
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Cytomegalovirus, Epstein-Barr virus and human herpesvirus 8 salivary shedding in HIV positive men who have sex with men with controlled and uncontrolled plasma HIV viremia: a 24-month longitudinal study. BMC Infect Dis 2018; 18:683. [PMID: 30567494 PMCID: PMC6300014 DOI: 10.1186/s12879-018-3591-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 12/04/2018] [Indexed: 02/07/2023] Open
Abstract
Background This longitudinal study described Cytomegalovirus (CMV) DNA, Epstein-Barr (EBV) DNA and human herpesvirus 8 (HHV-8) DNA asymptomatic salivary shedding in HIV-positive men who have sex with men (MSM). We aimed to 1-analyze frequency and persistence of herpesvirus shedding, 2-correlate herpesvirus positivity and HIV viroimmunological parameters and 3-assess the association between HIV-RNA suppression and herpesvirus replication. Methods Herpesvirus DNA was tested with an in-house real-time PCR in 2 salivary samples obtained at T0 and T1 (24 months after T0). HIV-RNA was evaluated in the 24 months prior to T0 and in the 24 months prior to T1; MSM were classified as successfully suppressed patients (SSPs), viremic patients (VPs) and partially suppressed patients (PSPs). EBV DNA load was classified as low viral load (EBV-LVL, value ≤10,000 copies/ml) and as high viral load (EBV-HVL,> 10,000 copies/ml). Mann-Whitney U test tested the difference of the median between groups of patients. Chi-squared test and Fisher’s exact test compared categorical variables according to the frequencies. Kruskal-Wallis test compared continuous data distributions between levels of categorical variables. Results Ninety-two patients (median CD4+ count 575 cells/mm3, median nadir 330 CD4+ cells/mm3) were included: 40 SSPs,33 VPs and 19 PSPs. The more frequently single virus detected was EBV, both at T0 and at T1 (in 67.5 and 70% of SSPs, in 84.8 and 81.8% of VPs and in 68.4 and 73.7% of SPSs) and the most frequently multiple positivity detected was EBV + HHV-8. At T1, the percentage of CMV positivity was higher in VPs than in SSPs (36.4% vs 5%, p < 0.001), the combined shedding of HHV-8, CMV and EBV was present only in VPs (15.1%, p = 0.01 respect to SSPs) and no VPs confirmed the absence of shedding found at T0 (vs 17.5% of SSPs, p = 0.01). EBV-HVL was more frequent in VPs than in SSPs: 78.6% at T0 (p = 0.03) and 88.9% at T1 (p = 0.01). Conclusions The relationship between uncontrolled plasma HIV viremia and CMV, EBV, and HHV-8 shedding is multifaceted, as demonstrated by the focused association with EBV DNA load and not with its frequency and by the persistent combined detection of two oncogenic viruses as EBV and HHV-8 regardless of HIV virological control. Electronic supplementary material The online version of this article (10.1186/s12879-018-3591-x) contains supplementary material, which is available to authorized users.
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Correa Sierra CB, Kourí Cardellá V, Pérez Santos L, Silverio CE, Hondal N, Florin J. Herpesviruses excretion in saliva of pediatric transplant recipients. Transpl Infect Dis 2017; 19. [DOI: 10.1111/tid.12771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/15/2017] [Accepted: 06/05/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Consuelo Beatriz Correa Sierra
- Sexually Transmitted Diseases Laboratory; Virology Department; Institute of Tropical Medicine “Pedro Kourí”; Havana Cuba
| | - Vivian Kourí Cardellá
- Sexually Transmitted Diseases Laboratory; Virology Department; Institute of Tropical Medicine “Pedro Kourí”; Havana Cuba
| | - Lissette Pérez Santos
- Sexually Transmitted Diseases Laboratory; Virology Department; Institute of Tropical Medicine “Pedro Kourí”; Havana Cuba
| | | | - Norma Hondal
- University Pediatric Hospital “William Soler”; Havana Cuba
| | - Jose Florin
- University Pediatric Hospital “Centro Habana”; Havana Cuba
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Otero RA, Nascimento FNN, Souza IPR, Silva RC, Lima RS, Robaina TF, Câmara FP, Santos N, Castro GF. LACK OF ASSOCIATION BETWEEN HERPESVIRUS DETECTION IN SALIVA AND GINGIVITIS IN HIV‑INFECTED CHILDREN. Rev Inst Med Trop Sao Paulo 2016. [PMID: 26200962 PMCID: PMC4544246 DOI: 10.1590/s0036-46652015000300007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The aims of this study were to compare the detection of human herpesviruses (HHVs) in
the saliva of HIV-infected and healthy control children, and to evaluate associations
between viral infection and gingivitis and immunodeficiency. Saliva samples were
collected from 48 HIV-infected and 48 healthy control children. Clinical and
laboratory data were collected during dental visits and from medical records. A
trained dentist determined gingival indices and extension of gingivitis. Saliva
samples were tested for herpes simplex virus types 1 and 2 (HSV-1 and HSV-2),
varicella zoster virus (VZV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) by
nested polymerase chain reaction assays. Thirty-five HIV-infected and 16 control
children had gingivitis. Seventeen (35.4%) HIV-infected children and 13 (27%) control
children were positive for HHVs. CMV was the most commonly detected HHV in both
groups (HIV-infected, 25%; control, 12.5%), followed by HSV-1 (6.2% in both groups)
and HSV-2 (HIV-infected, 4.2%; control, 8.3%). The presence of HHVs in saliva was not
associated with the presence of gingivitis in HIV-1-infected children
(p = 0.104) or healthy control children (p =
0.251), or with immunosuppression in HIV-infected individuals (p =
0.447). Gingivitis was correlated with HIV infection (p = 0.0001).
These results suggest that asymptomatic salivary detection of HHVs is common in
HIV-infected and healthy children, and that it is not associated with gingivitis.
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Affiliation(s)
- Renata A Otero
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Flávia N N Nascimento
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Ivete P R Souza
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Raquel C Silva
- Department of Virology, Microbiology Institute, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Rodrigo S Lima
- Department of Virology, Microbiology Institute, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Tatiana F Robaina
- Department of Virology, Microbiology Institute, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Fernando P Câmara
- Department of Virology, Microbiology Institute, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Norma Santos
- Department of Virology, Microbiology Institute, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Gloria F Castro
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, RJ, Brazil
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Slots J. Periodontal herpesviruses: prevalence, pathogenicity, systemic risk. Periodontol 2000 2015; 69:28-45. [DOI: 10.1111/prd.12085] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 12/13/2022]
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Santos L, Azevedo K, Silva L, Oliveira L. Epstein-Barr virus in oral mucosa from human immunodeficiency virus positive patients. Rev Assoc Med Bras (1992) 2014; 60:262-9. [DOI: 10.1590/1806-9282.60.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/06/2013] [Indexed: 11/22/2022] Open
Abstract
Objective: the detection rate of Epstein-Barr virus (EBV) is higher in people living with human immunodeficiency virus (HIV). In an attempt to contribute to our epidemiological understanding of this coinfection and to investigate the activity of EBV in normal oral mucosa, we performed a cross-sectional study with HIV-positive patients. Methods: oral smears from 145 HIV-positive patients were collected between March 2010 and March 2011. Nested polymerase chain reaction (PCR) and reverse transcriptase-PCR (RT-PCR) were used to genotype EBV and to detect EBNA-2 expression, respectively. Results: EBV DNA was detected in 48.3% of the study participants, of whom 32.85% were EBV-1 and 45.71% were EBV-2 carriers. Additionally, 14.28% were coinfected with both types. EBNA-2 mRNA was expressed in 45.7% of the EBV -positive samples, including 20.0% with EBV-1 only, 20.0% with EBV-2 only and 1.4% with both genotypes. Immune status affected the overall EBV infection, and EBV-2 positivity was significantly correlated with sexual lifestyle of the participants. EBV co-infection with both viral types was dependent upon HIV viral load and the activity of the EBNA-2 gene. Conclusion: we report a high prevalence of active EBV in the oral mucosa of asymptomatic HIV-seropositive individuals. This study addresses the need for monitoring and treatment of HIV-infected patients with EBV reactivation.
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Pinheiro RDS, Ferreira DDC, Nóbrega F, Santos NSDO, Souza IPRD, Castro GFBDA. Current status of herpesvirus identification in the oral cavity of HIV-infected children. Rev Soc Bras Med Trop 2013; 46:15-9. [PMID: 23563819 DOI: 10.1590/0037-868217172013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 12/13/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Some viruses of the Herpesviridae family are frequently the etiologic agents of oral lesions associated with HIV. The aim of this study was to identify the presence of herpes simplex virus types 1 and 2 (HSV-1, HSV-2), Varicella Zoster virus (VZV), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human herpesvirus type 6, type 7 and type 8 (HHV-6, HHV-7 and HHV-8) in the oral cavity of HIV-infected children/adolescents and verify the association between viral subtypes and clinical factors. METHODS The cells of oral mucosa were collected from 50 HIV infected children/adolescents, 3-13 years old (mean age 8.66). The majority (66%) of selected were girls, and they were all outpatients at the pediatric AIDS clinic of a public hospital in Rio de Janeiro. Nested-PCR was used to identify the viral types. RESULTS Absence of immunosuppression was observed in 66% of the children. Highly active antiretroviral therapy (HAART) was used by 72.1% of selected and moderate viral load was observed in 56% of the children/adolescents. Viral types were found in 86% of the children and the subtypes were: HSV-1 (4%), HSV-2 (2%), VZV (4%), EBV (0%), HCMV (24%), HHV6 (18%), HHV-7 (68%), HHV8 (0%). CONCLUSIONS The use of HAART has helped to reduce oral lesions, especially with herpes virus infections. The health professionals who work with these patients should be aware of such lesions because of their predictive value and the herpes virus can be found circulating in the oral cavity without causing lesions.
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