The effect of HAART on salivary microbiota in the Women's Interagency HIV Study (WIHS)

Objective. Study the prevalence of potentially pathogenic microorganisms in saliva of HIV-positive women in the Women's Interagency HIV Study. Study design. 157 HIV-positive and 31 HIV-negative women were studied. At baseline and every 6 months over 4 years, information was collected on socioeconomic and educational status, oral and systemic health, including HIV markers and antiretroviral therapy, and frequency of professional oral care utilization. Bacterial and yeast pathogenic isolates from stimulated whole saliva were tentatively identified using standard methodologies. Results. The prevalence of microorganisms in stimulated saliva of HIV-positive women was not significantly different from that of HIV-negative women. In HIV-positive women, highly active antiretroviral therapy (HAART) was independently and significantly associated with the presence of a variety of salivary bacterial species. HAART increased the risk for recovering Fusobacterium species (P < .001), enteric gram-negative rods (P < .05), Peptostreptococcus micros (P < .05), Campylobacter species (P < .0001), Eubacterium species (P < .001), and Tannerella forsythia (P < .01). In contrast, HAART led to decreased recovery rate of yeasts (Candida albicans and Candida dubliniensis) (P < .0001). Conclusion. The present findings suggest that the institution of HAART promotes an increasingly pathogenic salivary microbiota, at least temporarily. Similar findings have been reported for various nonoral microbial ecosystems.