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HIV shedding in the oral cavity: an assessment of HIV type, immunovirologic, demographic and oral factors
  1. Patricia B Pavlinac1,
  2. Stephen E Hawes1,
  3. Geoffrey S Gottlieb2,
  4. Awa Gaye3,
  5. Charlotte F N'Diaye3,
  6. Cathy W Critchlow4,
  7. Papa Salif Sow5,
  8. Qinghua Feng6,
  9. Nancy B Kiviat6
  1. 1Department of Epidemiology, University of Washington, Seattle, Washington, USA
  2. 2Department of Medicine, Division of Allergy & Infectious Diseases, School of Medicine, University of Washington, Seattle, Washington, USA
  3. 3Department of Dentistry, Université Cheikh Anta Diop, Dakar, Senegal
  4. 4Amgen Corporation, Thousand Oaks, California, USA
  5. 5Department of Infectious Diseases, Université Cheikh Anta Diop, Dakar, Senegal
  6. 6Department of Pathology, School of Medicine, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Stephen E Hawes, Department of Epidemiology, Box 359933, 325 Ninth Avenue, Seattle, WA 98104-2499, USA; hawes{at}


Objective To quantify the prevalence and burden of HIV type 2 (HIV-2) and HIV-1 RNA in the oral cavity of antiretroviral therapy-naive HIV-infected Senegalese individuals and to identify correlates of oral HIV viral loads.

Design A cross-sectional study of 163 HIV-1 and 27 HIV-2-infected antiretroviral therapy-naive Senegalese adults.

Methods Participants received clinical and oral exams and provided blood and oral wash samples for viral load and plasma CD4 count ascertainment. Logistic and interval regression models were used to identify univariate and multivariable associations between presence and level of oral HIV RNA and various immunovirologic, local and demographic factors.

Results Presence of detectable oral HIV RNA was less common in HIV-2-infected compared with HIV-1-infected study participants (33% vs 67%, OR 0.25, 95% CI 0.11 to 0.59). HIV type was no longer associated with oral shedding of HIV when plasma viral load was considered. Detection of oral HIV RNA was associated with increased plasma viral load in both HIV-1-infected and HIV-2-infected individuals (HIV-1, OR 1.89, 95% CI 1.24 to 2.61; HIV-2, OR 1.93, 95% CI 1.1 to 3.39). Oral HIV-1 detection was also associated with periodontal disease (OR 3.02, 95% CI 1.16 to 7.87).

Conclusions Oral shedding of HIV-2 RNA is less common than HIV-1 RNA, a likely consequence of lower overall viral burden. Both systemic and local factors may contribute to shedding of HIV in the oral cavity.

  • Africa
  • HIV
  • oral cavity
  • epidemiology
  • AIN
  • chlamydia
  • STDS
  • homosexual
  • cervical cancer
  • CIN
  • partner notification
  • health service research
  • syndromic management
  • gonorrhoea
  • resistance
  • men

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  • Funding This study was supported by grants from the National Institutes of Health (AI37466, CA62801, DE011372).

  • Competing interests None.

  • Ethics approval University of Washington Institutional Review Board, University of Dakar Institutional Review Board and the Senegalese National AIDS committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.