Pre- and post-HAART HIV viral loads in blood and saliva

Objectives: The recent introduction of Highly Active Anti-Retroviral Therapy (HAART) has led to prolonged survival in many HIV-infected patients. This study was designed to clarify relationship between viral loads in blood and saliva before and after HAART. Methods: The study included 10 HIV-infected patients upon informed consent. A total of 60 samples, 30 each for blood and saliva, were collected before, 4 weeks and 8 weeks after three-drug combination therapy including protease inhibitors (HAART) for viral load measurement with an HIV-1 RNA kit (AMPLICOR HIV-1 MONITOR with a detection limit of 50 copies/ml). Blood was drawn by standard technique, and approximately 1ml of saliva was directly expectorated into a Salivette container. For saliva sampling, each subject was instructed to avoid stimulation of the oral mucosa during tooth brushing or kissing and not to use dentifrice for brushing from the night before to the time of sampling, in order to minimize contamination of saliva samples with blood or chemical substances. Both blood and saliva samples were collected around the same time of the day, namely, before lunch, to ensure accuracy of data. Results: Significant differences in blood viral load were observed at 4 weeks (mean of 17,000) and 8 weeks (< 50) after HAART as compared to before HAART (208,000) (p<0.05). In contrast, viral loads in saliva were below 50 at all three time points. Thus, there was no correlation between viral loads in saliva and blood. Conclusion: The results showed that changes in viral load before and after HAART could not be determined by saliva analysis. The study also reconfirmed that the risk of HIV transmission would be minimal when exposed to saliva uncontaminated with blood.