Oral lesions in HIV infected individuals from Ribeirão Preto, Brazil

Objectives: The aim of this study was to diagnosis oral lesions related to HIV infection in individuals followed in the General Hospital of the School of Medicine of Ribeirão Preto, University of São Paulo, Brazil. The presence of oral lesions was correlated with gender, age, smoking habit, levels of CD4 lymphocytes, HIV load, time of HIV seropositivity, AIDS condition, use of removable dental prosthesis, and use of HAART. Materials and Methods: 340 HIV infected individuals were selected for this study, all participants of the study were examined by only one practiced dentist which performed anamnesis, peribuccal and oral examination. Results: Oral lesions were observed in 113 of 340 (33.2%) HIV infected individuals. These oral lesions included: oral candidiasis (17.7%) of pseudomembranous (10.8%) and of erythematous types (6.9%), angular cheilitis (13.9%), hairy leukoplakia (11.8%), and oral ulcers (2.1%). Oral candidiasis lesions were more frequently observed in women (p.033). Smoking addict participants presented a high frequency of tongue hairy leukoplakia (p.038) and a reduced frequency of oral ulcers (p.018). Hairy leukoplakia and pseudomembranous candidiasis were inversely correlated to CD4+L levels and directly correlated with HIV load, behaving as immune depression markers. Hairy leukoplakia and pseudomembranous candidiasis also showed an inverse correlation with HAART use (p<.0001). Patients using mobile dental prosthesis presented a high frequency of erythematous candidiasis (p.003). Conclusion: The inverse correlation with CD4+L level and the direct correlation with HIV load suggest that oral lesions could be used as alternative clinical markers for poor immune condition in HIV infected individuals

Oral Candida spp carriage and periodontal diseases in HIV-infected patients in Ribeirão Preto, Brazil

The majority of HIV-infected patients develop Candida spp-associated clinical oral lesions. Studies have shown that asymptomatic oral colonization of Candida spp may lead to oral lesions or become a source of disseminated infections. The aim of this study was to verify the effects of periodontal conditions on Candida spp prevalence and Candida spp carriage in the oral cavity of HIV-infected patients compared to non-infected patients. Twenty-five patients not infected with HIV and 48 HIV-infected patients were classified according to periodontal conditions as being periodontal healthy or with periodontal disease. Candida spp carriage and classification were performed in oral rinse samples. Viral load and CD4+ T lymphocyte (CD4+L) counts were performed in blood samples from HIV-infected patients. No differences in Candida spp prevalence related to HIV status or periodontal condition were detected. However, Candida spp carriage was increased in periodontally affected HIV-infected patients when compared to periodontally healthy HIV-infected patients (p= 0.04). Periodontally healthy HIV-infected patients presented Candida spp carriage in similar levels as healthy or periodontally affected non-HIV-infected patients. Candida spp carriage was correlated with CD4+L counting in HIV-infected patients. We concluded that periodontal disease is associated with increased Candida spp carriage in HIV-infected patients and may be a predisposing factor to clinical manifestations of candidiasis

Estudo in vitro da capacidade da lactoferrina e de seu produto de clivagem (G-12-I), presentes nas secreções orais e genitais, de modular a produção de CCL20 pelas células do epitélio endocervical : envolvimento com a transmissão sexual do HIV

Dendritic cells, among them Langerhans cells, are recognized as presenters of Human Immunodeficiency Virus (HIV) to CD4 + T lymphocytes. The recruitment of Langerhans cells in the vaginal mucosa is modulated by Chemokine CC motif ligand 20 (CCL20) produced by epithelial cells of the female genital mucosa. The aim of this study was to evaluated the capacity of seminal plasma, saliva and vaginal secretions to induce the production of CCL20 by monostratified endocervical epithelium cells culture (HEC-1A), also, the relation of this production with the presence of lactoferrin and its cleavage products (G- 12-I) in seminal plasma and saliva. Cultures of HEC-1A cells were stimulated with seminal plasma, saliva and vaginal secretions of HIV-seronegative and HIV-seropositive participants, and the CCL20 production measured by enzyme linked immunosorbent assay (ELISA) in its cellular supernatant. ELISA for Lf was performed on all samples, and the peptide cleavage Lf (G-12-I) observed in the samples which more and less induced the CCL20 secretion on western blot. We observed that the seminal plasma of seropositive participants were responsible for a higher stimulation of CCL20 production by HEC-1A cells, when compared to the seminal plasma of HIV-seronegative participants. Lf concentration in seminal plasma was positively related to the CCL20 production by HEC-1A cells, the higher production of CCL20 was also more associated with Lf peptide cleavage Lf (G-12-I), on western blot. Saliva stimulated CCL20 production by HEC-1A cells, and such stimulation was not correlated to Lf concentration. In conclusion, the presence of Lf in seminal plasma positively related to the production of CCL20 by HEC-1A cells, and saliva may induce the production of CCL20 in the female genital mucosaLes cellules dendritiques présentes dans les muqueuses comme les cellules de Langerhans, sont capables de présenter le Virus d'Immunodéficience Humaine (VIH) aux lymphocytes T CD4+, aboutissant à l'infection par le VIH lors de contacts hétérosexuels non protégés. Le recrutement des cellules de Langerhans dans la muqueuse vaginale est assuré par la chimiokine Quimiocin C-C motif ligant 20 (CCL20) produite par les cellules épithéliales de la muqueuse. L'objectif de ce travail a été d’étudier la capacité du plasma séminal, de la salive et de la sécrétion vaginale à stimuler la production de CCL20 par les cellules de l’épithélium endocervical (cellules HEC-1A), et de corréler cette production avec la présence de la lactoferrine (LF) et de ses produits de clivage dans ces différents fluides biologiques. Des cellules HEC-1A ont été cultivées avec les plasmas séminaux, les salives et les sécrétions vaginales de patients séronégatifs et séropositifs pour le VIH, et la production de CCL20 a été mesurée dans les surnageants cellulaires en ELISA. Le dosage de la Lf par ELISA a été réalisé sur tous les échantillons. La présence d’un petide de clivage de la Lf (G-12-I) a été analysée en western blot. Les résultats obtenus montrent que les plasmas séminaux des patients séropositifs ont une plus grande capacité à stimuler la sécrétion de CCL20 que les patients séronégatifs pour le VIH. La concentration de la Lf dans le plasma séminal est corrélée à la stimulation de cette sécrétion par les cellules HEC-1A. Il semble que les échantillons ayant la plus grande capacité à stimuler la sécrétion de CCL20 possèdent une plus forte concentration en petide de clivage de la Lf (G-12-I), bien que ce résultat, obtenu en western blot. La salive est également capable de stimuler de la production de CCL20 par les cellules HEC-1A, mais cette stimulation n'est pas corrélée avec sa concentration en Lf. Nous concluons que la sécrétion de CCL20 par l’épithélium génital féminin induite par le plasma séminal est corrélée à la présence de la Lf dans ce fluide. Bien que les mécanismes puissent être différents, la salive peut également induire la production de CCL20 par les cellules épithéliales de la muqueuse génitale féminineAs células dentríticas, dentre elas as células de Langerhans, são capazes de apresentar o vírus da imunodeficiência humana (HIV) aos linfócitos T CD4+, cujo processo culmina com a infecção por esse vírus. O recrutamento das células de Langerhans na mucosa vaginal é modulada pela Quimiocin C-C motif ligant 20 (CCL20), produzida pelas células epiteliais da mucosa genital feminina. O objetivo desse trabalho foi estudar a capacidade do plasma seminal, da saliva e do conteúdo vaginal de induzir a produção de CCL20 pela cultura de células do epitélio monoestratificado endocervical (HEC-1A), relacionando tal produção com a presença da lactoferrina (Lf) e de seu produto de clivagem (G-12-I) nestes fluidos. Culturas de células HEC-1A foram estimuladas com plasmas seminais, salivas e conteúdos vaginais de participantes soronegativos e soropositivos para o HIV, visando avaliar a produção de CCL20, a qual foi mensurada utilizando-se o Enzyme Linked Immunosorbent Assay (ELISA). A dosagem de Lf (ELISA) foi realizada em todas as amostras estudadas e a presença do peptídeo de clivagem da Lf (G-12-I) observada nas amostras que mais e que menos induziram a secreção de CCL20 pelas células HEC-1A por Western blot. Verificou-se que os plasmas seminais de participantes soropositivos foram responsáveis por maior estimulação da produção de CCL20 pelas células HEC-1A, quando comparados aos plasmas seminais de participantes soronegativos para o HIV. A concentração de Lf no plasma seminal associou-se à indução na produção de CCL20 pelas células HEC-1A, assim como as amostras que mais induziram a produção de CCL20 apresentaram presenças mais evidentes do peptídeo de clivagem da Lf (G-12-I). A saliva foi responsável pela estimulação na produção de CCL20 pelas células HEC-1A, no entanto, tal estimulação não se associou à concentração de Lf salivar. Concluímos que a presença de Lf no plasma seminal esteve correlacionada à produção de CCL20 pelas células HEC-1A, e que a saliva pode induzir a produção da CCL20 pelas células epiteliais endocervicai

Étude in vitro de la capacité de la lactoferrine et son produit de clivage (G-12-I), présent dans les sécrétions orales et génitales, de moduler la production de CCL20 par les cellules épithéliales endocervicales : implication dans la transmission sexuelle du VIH

Les cellules dendritiques présentes dans les muqueuses comme les cellules de Langerhans, sont capables de présenter le Virus d'Immunodéficience Humaine (VIH) aux lymphocytes T CD4+, aboutissant à l'infection par le VIH lors de contacts hétérosexuels non protégés. Le recrutement des cellules de Langerhans dans la muqueuse vaginale est assuré par la chimiokine Quimiocin C-C motif ligant 20 (CCL20) produite par les cellules épithéliales de la muqueuse. L'objectif de ce travail a été d’étudier la capacité du plasma séminal, de la salive et de la sécrétion vaginale à stimuler la production de CCL20 par les cellules de l’épithélium endocervical (cellules HEC-1A), et de corréler cette production avec la présence de la lactoferrine (LF) et de ses produits de clivage dans ces différents fluides biologiques. Des cellules HEC-1A ont été cultivées avec les plasmas séminaux, les salives et les sécrétions vaginales de patients séronégatifs et séropositifs pour le VIH, et la production de CCL20 a été mesurée dans les surnageants cellulaires en ELISA. Le dosage de la Lf par ELISA a été réalisé sur tous les échantillons. La présence d’un petide de clivage de la Lf (G-12-I) a été analysée en western blot. Les résultats obtenus montrent que les plasmas séminaux des patients séropositifs ont une plus grande capacité à stimuler la sécrétion de CCL20 que les patients séronégatifs pour le VIH. La concentration de la Lf dans le plasma séminal est corrélée à la stimulation de cette sécrétion par les cellules HEC-1A. Il semble que les échantillons ayant la plus grande capacité à stimuler la sécrétion de CCL20 possèdent une plus forte concentration en petide de clivage de la Lf (G-12-I), bien que ce résultat, obtenu en western blot. La salive est également capable de stimuler de la production de CCL20 par les cellules HEC-1A, mais cette stimulation n'est pas corrélée avec sa concentration en Lf. Nous concluons que la sécrétion de CCL20 par l’épithélium génital féminin induite par le plasma séminal est corrélée à la présence de la Lf dans ce fluide. Bien que les mécanismes puissent être différents, la salive peut également induire la production de CCL20 par les cellules épithéliales de la muqueuse génitale féminineDendritic cells, among them Langerhans cells, are recognized as presenters of Human Immunodeficiency Virus (HIV) to CD4 + T lymphocytes. The recruitment of Langerhans cells in the vaginal mucosa is modulated by Chemokine CC motif ligand 20 (CCL20) produced by epithelial cells of the female genital mucosa. The aim of this study was to evaluated the capacity of seminal plasma, saliva and vaginal secretions to induce the production of CCL20 by monostratified endocervical epithelium cells culture (HEC-1A), also, the relation of this production with the presence of lactoferrin and its cleavage products (G- 12-I) in seminal plasma and saliva. Cultures of HEC-1A cells were stimulated with seminal plasma, saliva and vaginal secretions of HIV-seronegative and HIV-seropositive participants, and the CCL20 production measured by enzyme linked immunosorbent assay (ELISA) in its cellular supernatant. ELISA for Lf was performed on all samples, and the peptide cleavage Lf (G-12-I) observed in the samples which more and less induced the CCL20 secretion on western blot. We observed that the seminal plasma of seropositive participants were responsible for a higher stimulation of CCL20 production by HEC-1A cells, when compared to the seminal plasma of HIV-seronegative participants. Lf concentration in seminal plasma was positively related to the CCL20 production by HEC-1A cells, the higher production of CCL20 was also more associated with Lf peptide cleavage Lf (G-12-I), on western blot. Saliva stimulated CCL20 production by HEC-1A cells, and such stimulation was not correlated to Lf concentration. In conclusion, the presence of Lf in seminal plasma positively related to the production of CCL20 by HEC-1A cells, and saliva may induce the production of CCL20 in the female genital mucosaAs células dentríticas, dentre elas as células de Langerhans, são capazes de apresentar o vírus da imunodeficiência humana (HIV) aos linfócitos T CD4+, cujo processo culmina com a infecção por esse vírus. O recrutamento das células de Langerhans na mucosa vaginal é modulada pela Quimiocin C-C motif ligant 20 (CCL20), produzida pelas células epiteliais da mucosa genital feminina. O objetivo desse trabalho foi estudar a capacidade do plasma seminal, da saliva e do conteúdo vaginal de induzir a produção de CCL20 pela cultura de células do epitélio monoestratificado endocervical (HEC-1A), relacionando tal produção com a presença da lactoferrina (Lf) e de seu produto de clivagem (G-12-I) nestes fluidos. Culturas de células HEC-1A foram estimuladas com plasmas seminais, salivas e conteúdos vaginais de participantes soronegativos e soropositivos para o HIV, visando avaliar a produção de CCL20, a qual foi mensurada utilizando-se o Enzyme Linked Immunosorbent Assay (ELISA). A dosagem de Lf (ELISA) foi realizada em todas as amostras estudadas e a presença do peptídeo de clivagem da Lf (G-12-I) observada nas amostras que mais e que menos induziram a secreção de CCL20 pelas células HEC-1A por Western blot. Verificou-se que os plasmas seminais de participantes soropositivos foram responsáveis por maior estimulação da produção de CCL20 pelas células HEC-1A, quando comparados aos plasmas seminais de participantes soronegativos para o HIV. A concentração de Lf no plasma seminal associou-se à indução na produção de CCL20 pelas células HEC-1A, assim como as amostras que mais induziram a produção de CCL20 apresentaram presenças mais evidentes do peptídeo de clivagem da Lf (G-12-I). A saliva foi responsável pela estimulação na produção de CCL20 pelas células HEC-1A, no entanto, tal estimulação não se associou à concentração de Lf salivar. Concluímos que a presença de Lf no plasma seminal esteve correlacionada à produção de CCL20 pelas células HEC-1A, e que a saliva pode induzir a produção da CCL20 pelas células epiteliais endocervicai

Oral health management of 97 patients living with HIV/AIDS in Ribeirão Preto, São Paulo, Brazil

Considering the changes antiretroviral therapy (ART) has brought to the treatment of HIV infection, the current clinical and laboratory profiles of HIV/AIDS individuals referred to oral health centers are crucially important in instructing dentists about the oral health management of these patients. The aim of the present study was to determine the clinical and laboratory profiles of HIV-infected individuals referred to a clinic for patients with special needs between 2005 and 2012 by retrospectively analyzing their dental records. A total of 97 records of HIV patients referred to the School of Dentistry of Ribeirão Preto, Universidade de São Paulo - USP, were analyzed. The Mann-Whitney test was used to determine the associations between mean CD4+ counts, mean viral load, and the presence of HIV-related oral lesions (HIV-OL). Most of the patients were male, and their mean age was 38.3 years. Eighty-nine (92%) patients were on regular ART, 77 (79.4%) had a CD4+ count higher than 200 cells/mm3, and 63 (64.9%) had an undetectable viral load. Twenty patients (20.6%) presented with some HIV-OL, including pseudomembranous and/or erythematous candidiasis and angular cheilitis, which were correlated with a low CD4+ count and with an undetectable viral load (p < 0.05). Among the branches of dentistry, periodontics, followed by surgery and restorative dentistry, was the most sought-after specialty, and no intercurrent events were observed during the dental treatment. It may be concluded that there are no restrictions on the dental treatment of patients on regular ART, It is important, though, that the treatment be based on local characteristics and on the prevention of oral diseases.</p