The Association among HIV Disease Markers, HAART, Oral Health, and Saliva HIV Viral Load in HIV-infected Women

Objectives: Investigate the relationship among HIV immunologic and virologic disease markers, oral health parameters and saliva HIV viral load in a nested group (n=78) of HIV infected participants of the Women’s Interagency HIV Study (WIHS) in Los Angeles. Methods: Samples of oral rinse, unstimulated and stimulated saliva were collected under standard conditions. Oral health parameters included coronal and root caries, gingival and periodontal diseases and soft tissue lesions. Quantification of HIV-1 RNA in plasma,saliva and oral rinse was performed utilizing the NASBA/Nuclisens (BioMerieux, Durham, NC) method. Data analysis utilized chi square tests and multivariate logistic regression models. Results: Significant (p<0.001) associations were found between plasma HIV viremia, unstimulated and stimulated saliva and oral rinse HIV viral loads. Women with detectable plasma viral load were significantly more likely to have detectable saliva or oral rinse viral load as compared to women with undetectable plasma viral load (>10,000 & <10,000 copies/ml odds ratios 12.2 and 6.4 respectively, p<0.001). Similar association was found for CD4 cell counts (<200 & 200-500 vs. >500, odds ratios 12.0 and 4.9, p<0.001) and for HAART naive vs. being on HAART (odds ratio 5.9, p<0.01). Gingival recession, plaque index, and papillary edema were also associated with saliva viral loads significantly or marginally significantly (p<0.003, p=0.054, p=0.054, respectively). Plasma viral load, CD4 cell counts and plaque index were independent and significant (p<0.0001, p<0.0001, p<0.01, respectively) predictors of saliva viral load in the multivariate analysis. Conclusions: Saliva HIV viral load is significantly affected by selected HIV disease markers and oral health parameters. Supported by NIDCR # 5U01 HD32632-07.