Detection of EBV, CMV and HSV-1 in subgingival samples of HIV positive and negative patients with chronic periodontitis / Detección de VEB, CMV y VHS-1 en muestras subgingivales de pacientes VIH positivos y negativos con periodontitis crónica

Abstract: objective: to detect the presence of infection by EBV (Epstein-Barr Virus), CMV (Cytomegalovirus) and HSV-1 (Herpes Simplex Virus type 1) in subgingival samples from HIV- positive patients under HAART (High Activity Antiretroviral Therapy), HIV- positive patients without HAART, HIV-negative patients with chronic periodontitis and healthy controls. Methodology: Crevicular fluid samples of 11 HIV+ patients on therapy were evaluated, 6 without antiretroviral therapy, 7 HIV- negative subjects with chronic periodontitis and 7 periodontally-healthy controls. PI (Plaque index), GI (Gingival Index), PD (probing depth) and CAL (Clinical Attachment Loss) were registered at six sites per each tooth in all teeth and subgingival plaque samples of a tooth were collected per quadrant. Nested PCR was used to detect EBV and endpoint PCR to detect infection by CMV and HSV-1. Results: Clinical parameters showed statistically significant differences between HIV-positive patients and subjects with chronic periodontitis compared with the control group (p<0.05). DNA of EBV was detected mainly in HIV-positive patients under HAART, 91 percent (10/11). DNA of CMV was detected mainly in patients without HAART, 67 percent (4/6), while HSV-1 was observed in 27 percent (3/11) of patients under HAART. In the control group no virus was detected. Coinfection was observed in 50 percent of HIV patients without HAART, 36 percent of HIV patients with HAART and 14 percent of HIV-negative with chronic periodontitis. Conclusion: Viral infection was prevalent in HIV patients under HAART and EBV was the primary viral infection detected in HIV-positive patients with chronic periodontitis.

Resumen: detectar la presencia de infección por VEB (Virus Epstein-Barr), CMV (Citomegalovirus) y VHS-1 (Virus Herpes simple tipo 1) en muestras subgingivales de pacientes VIH-positivos bajo HAART (Terapia Anti Retroviral de Alta Actividad), VIH-positivos sin HAART, pacientes VIH-negativos con periodontitis crónica y controles sanos. Metodología: Se evaluaron muestras de fluido crevicular de 11 pacientes VIH+ bajo terapia, 6 sin terapia antiretroviral, 7 sujetos VIH–negativo con periodontitis crónica y 7 controles periodontalmente sanos. Se registró el IP (Índice de placa), IG (Índice Gingival), PS (Profundidad del Sondaje) y NIC (Nivel de Inserción Clínica) en seis sitios por diente en todos los dientes y se recolectaron muestras de placa subgingival de un diente por cuadrante. Se empleó PCR anidada para detectar VEB y PCR punto final para identificar la infección con CMV y VHS-1. Resultados: Los parámetros clínicos mostraron diferencias estadísticamente significativas entre pacientes VIH-positivos y sujetos con periodontitis crónica comparados con el grupo control (p<0.05). El ADN de EBV fue detectado principalmente en pacientes VIH-positivos bajo HAART con 91 por ciento (10/11). El ADN de CMV se detectó principalmente en pacientes sin HAART, 67 por ciento (4/6), mientras que VHS-1 se observó en 27 por ciento (3/11) de los pacientes bajo HAART. En el grupo control no se detectó ningún virus. La coinfección fue observada en 50 por ciento de los pacientes VIH sin HAART, 36 por ciento de los VIH con HAART y 14 por ciento de los VIH negativos con periodontitis crónica. Conclusión: La infección viral fue predominante en los pacientes VIH bajo HAART y VEB fue la principal infección viral detectada en los pacientes VIH positivos y con periodontitis crónica.

Detection of human papillomavirus in dental biofilm and the uterine cervix of a pregnant adolescent / Detecção do papilomavírus humano em biofilme dental e no colo uterino de uma adolescente grávida

CONTEXT: Adolescence and pregnancy are considered to be risk factors for human papillomavirus (HPV) infection. The relationship between this infection in the uterine cervix and oral HPV infection is controversial. CASE REPORT: This report describes a case of a pregnant 16-year-old adolescent who presented HPV infection in the uterine cervix and the mouth. Smears were collected from the cervix and the tongue/palate. Dental biofilm samples were also collected. The microarray technique was used to detect HPV. The HPV 56 subtype was observed in the cervical smear and HPV 6 in dental biofilm. CONCLUSION: In this pregnant adolescent, HPV infection was present in both the cervix and the mouth, but the HPV subtypes infecting these two areas were different.

CONTEXTO: A adolescência e a gestação são consideradas fatores de risco para a infecção pelo papilomavírus humano (HPV). A relação entre essa infecção no colo do útero e na boca num mesmo paciente é controversa. RELATO DE CASO: Descrever o caso de uma adolescente grávida de 16 anos que apresentou a infecção pelo HPV no colo do útero e na boca. Esfregaços foram realizados no colo do útero e em língua/palato. Amostras de biofilme dental também foram coletadas. Para detectar o HPV, foi utilizada a técnica do microarranjo. O HPV 56 foi o subtipo encontrado no esfregaço cervical e o tipo HPV 6 no biofilme dental. CONCLUSÕES: Observamos, nessa adolescente grávida, a presença do HPV na boca e no colo do útero, mas os subtipos virais que infectavam essas duas regiões eram distintos.

EBV-1 and HCMV in aggressive periodontitis in Brazilian patients

The purpose of the present investigation was to compare the presence of Epstein-Barr virus type 1 (EBV-1) and of Human Cytomegalovirus (HCMV) in crevicular fluid samples from deep and shallow periodontal pocket sites of Brazilian patients with aggressive periodontitis. A total of 30 systemically healthy patients with aggressive periodontitis participated in the study. Paper points were inserted into 2 gingivitis sites (< 3 mm) and into 2 periodontitis sites (> 5 mm) in each patient. PCR assay was used to identify genomic copies of HCMV and EBV-1. Twenty-three patients (77 percent) were positive for EBV-1, while only 2 patients (6 percent) were positive for HCMV. The McNemar test revealed a positive association between EBV-1 and periodontal lesions (p = 0.043). Thirty-four (57 percent) out of 60 periodontitis sites were positive for EBV-1, whereas 18 (30 percent) gingivitis sites were positive (p = 0.01). Only two sites (6.7 percent) were positive for HCMV. No positive association was found between HCMV and periodontitis or gingivitis (p = 0.479). The elevated occurrence of EBV-1 DNA in periodontal pockets of patients with aggressive periodontitis supports a possible periodontopathic role of this virus.

O objetivo do presente estudo foi comparar a presença do vírus Epstein-Barr tipo 1 (EBV-1) e do Citomegalovírus Humano (HCMV) em amostras de fluido crevicular de bolsas periodontais rasas e profundas de pacientes brasileiros com periodontite agressiva. Trinta pacientes sistemicamente saudáveis com periodontite agressiva participaram deste estudo. Cones de papel foram inseridos em 2 sítios de gengivite (< 3 mm) e em 2 sítios de periodontite (> 5 mm) de cada paciente. Reações de PCR foram usadas para identificar cópias de DNA genômico de HCMV e EBV-1. Em 23 pacientes (77 por cento), os testes foram positivos para EBV-1, enquanto apenas 2 pacientes (6 por cento) foram positivos para HCMV. O teste de McNemar apontou associação positiva entre EBV-1 e lesões periodontais (p = 0,043). Trinta e quatro (57 por cento) dos 60 sítios de periodontites foram positivos para o EBV-1, enquanto 18 (30 por cento) dos sítios de gengivites foram positivos (p = 0,01). Apenas 2 sítios (6,7 por cento) foram positivos para o HCMV. Não foi encontrada associação positiva entre HCMV e periodontite ou gengivite (p = 0,479). A alta ocorrência de DNA de EBV-1 em bolsas periodontais de pacientes com periodontite agressiva corrobora a possível função periodontopática deste vírus.