To explore the type and prevalence of oral mucosal lesions among adults with primary HIV infection (PHI) compared with HIV-negative adults at high risk for HIV disease, and in relation to HIV viral load.
We conducted standardized oral examinations to identify specific oral mucosal lesions among adults with PHI, both pre-seroconversion and post- seroconversion-recently infected, compared with HIV-negative adults. We compared the group with oral lesions to those without oral lesions with respect to HIV-RNA load and CD4 + T-cell count.
Among 115 adults (predominantly men), pseudomembranous candidiasis was the most common oral lesion among those with PHI, and was found in 4% of the 23 participants in pre-seroconversion and in 9% of 69 participants with post-seroconversion recent infection, compared with none found among 23 HIV negatives. Among those with PHI, the median viral load was higher and the median CD4 + T-cell count lower among the 15 participants with an oral lesion of any type than among the 77 participants without oral lesions (P = 0.02 and 0.04, respectively).
This finding suggests that individuals with PHI who have oral lesions may be more likely to transmit HIV because of their higher viral load.
"Matching saliva and plasma samples (2 ml of each) from HIV-infected (UCSF Options Study, Owotade et al., 2008) and HIV-uninfected individuals were subjected to immunoprecipitation using sheep anti-tat (Abcam) and mouse monoclonal anti- gp120 antibodies (ID6) (NH AIDS Reagents). These samples (concentrated by approximately 20 times) were then analyzed by immunoblotting with mouse anti-tat monoclonal (Immunodiagnostics Inc) and mouse anti-gp120 antibodies (ID6) (NIH AIDS Research reagent program). "
[Show abstract][Hide abstract] ABSTRACT: The incidence of human papillomavirus (HPV)-associated epithelial lesions is substantially higher in human immunodeficiency virus (HIV)-infected individuals than in HIV-uninfected individuals. The molecular mechanisms underlying the increased risk of HPV infection in HIV-infected individuals are poorly understood. We found that HIV proteins tat and gp120 were expressed within the oral and anal mucosal epithelial microenvironment of HIV-infected individuals. Expression of HIV proteins in the mucosal epithelium was correlated with the disruption of epithelial tight junctions (TJ). Treatment of polarized oral, cervical and anal epithelial cells, and oral tissue explants with tat and gp120 led to disruption of epithelial TJ and increased HPV pseudovirion (PsV) paracellular penetration in to the epithelium. PsV entry was observed in the basal/parabasal cells, the cells in which the HPV life cycle is initiated. Our data suggest that HIV-associated TJ disruption of mucosal epithelia may potentiate HPV infection and subsequent development of HPV-associated neoplasia.
"s ) and the acquired response ( an increase in circulating and mucosal IgG and mucosal IgA antibodies ) work together to keep Candida in check in a colonized healthy host ( Fidel , 2006 ) . However , very early infection with HIV has been demon - strated to influence colonization with oral Candida and the development of opportunistic candidiasis ( Owotade et al . , 2008 ) . This is a consequence of defective T helper 1 - type CD4 + T cells and changes in saliva composition and function ( Fidel , 2006 ) ."
[Show abstract][Hide abstract] ABSTRACT: There is paucity of information about the factors associated with oral colonization with Candida species and the changes with antiretroviral therapy in our study population. This study investigated the role of antiretroviral therapy and other factors. Relevant clinical and laboratory information was obtained and oral rinse specimens tested for yeast identification. Findings were compared with previous data from the same clinic before antiretroviral therapy was available. Of the 197 patients, 117 (59.4%) were colonized. Candida albicans was the most dominant species (71%) and Candida dubliniensis was the most frequent non-albicans Candida. The colonized group had a higher rate of concurrent tuberculosis infection (77.4% compared with 56% in the non colonized, P=0.03) and higher median CD4+ count, 418 cell/mm3, compared with the non-colonized group with 346.5 cell/mm3. Participants not on antiretroviral therapy and those having oral prosthesis were all colonized, P=0.003 and 0.022, respectively. Oral Candida count was negatively correlated with the CD4+ count in participants on antiretroviral therapy, P=0.006. Associated factors using logistic regression were dental caries (OR=1.30; 95%CI=1.07, 1.60;) and diabetes mellitus (OR=5.52; 95%CI=1.68, 18.12;). The colonization rate was higher (81.3%) and yeast count before antiretroviral therapy was available and the prevalence of C. dubliniensis has increased from 6.3% to 11%. Dental caries, diabetes mellitus, oral prostheses, and tuberculosis infection were associated with oral colonization. Colonization rate, variety and count of yeast have declined with antiretroviral therapy.
Journal of Medical Microbiology 01/2013; 62(Pt_1):126-132. DOI:10.1099/jmm.0.047522-0 · 2.25 Impact Factor
"As the most common opportunistic infection, the incidence of oral candidiasis has increased rapidly for several decades due to the growing number of compromised hosts, such as patients with organ transplants or HIV infection or those undergoing chemotherapy or misusing antibiotics. In particular, oral candidiasis has much greater prevalence in immunocompromised individuals, such as patients with HIV infection (66%)  and Sjögren's syndrome (54.2–80%)  . In addition, an important trend that can be detected with the incidence of oral candidiasis is an increase in the number of infections related to the non-albicans Candida species such as Candida glabrata, Candida krusei, and Candida tropicalis. "
[Show abstract][Hide abstract] ABSTRACT: This study was designed to evaluate the in vitro antifungal activities of four traditional Chinese medicine (TCM) extracts. The inhibitory effects of pseudolaric acid B, gentiopicrin, rhein, and alion were assessed using standard disk diffusion and broth microdilution assays. They were tested against six oral Candida species, Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida dubliniensis, and Candida guilliermondii, including clinical isolates from HIV-negative, HIV-positive, and Sjögren's syndrome patients. It was found that pseudolaric acid B had the most potent antifungal effect and showed similar antifungal activity to all six Candida spp, and to isolates from HIV-negative, HIV-positive, and Sjögren's syndrome patients. The MIC values ranged from 16 to 128 μg/mL. More interestingly, a synergistic effect of pseudolaric acid B in combination with fluconazole was observed. We suggest that pseudolaric acid B might be a potential therapeutic fungicidal agent in treating oral candidiasis.
Evidence-based Complementary and Alternative Medicine 02/2012; 2012(5):106583. DOI:10.1155/2012/106583 · 1.88 Impact Factor
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