Periodontal Pathogens and Reactivation of Latent HIV Infection: A Review of the Literature

Abstract

Purpose: Infection by the human immunodeficiency virus (HIV) causes the host to have a compromised immune system due to the virus's ability to infect cells of the immune system, such as helper T-cells (specifically CD4+ T-cells), macrophages and dendritic cells. HIV remains latent within these cells, which function as memory cells and remains in the body for years. People who have a compromised immune system caused by HIV are more highly susceptible to other infections, including periodontal disease. Until recently, very little attention has been given to the potential interactions between chronic oral infections, such as periodontal disease and latent HIV reactivation/upregulation. This review focuses on the literature available between 2009 and 2011, evaluating the potential link between bacterial infections, including oral infections caused by periodontal pathogens, the reactivation of latent HIV leading to the potential failure of highly active antiretroviral therapy and acquired immunodeficiency syndrome (AIDS) progression. It has been hypothesized that infections by periodontal pathogens can stimulate reactivation of HIV-latently infected cells. Studies showed that soluble factors produced in response to periodontal pathogens by gingival cells could be indirect contributors to HIV-1 promoter activation. It was also found that the oral bacteria stimulated the HIV promoter activation in a dose-dependent and time-dependent manner. While these preliminary studies present a potential link between oral periodontal pathogens and HIV reactivation, additional clinical and epidemiological studies are needed to clarify the causal link and mechanisms of HIV latency reactivation associated with oral pathogens.