Significant effect of HIV/HAART on oral microbiota using multivariate analysis

Ann L Griffen,Eugene J Leys,Paul L Fidel,Kelly D Treas,Chiranjit Mukherjee,Kenneth R Dubois,Michael E Hagensee,Shahr B Hashmi,Clifford J Beall,Elizabeth A Lilly,Aubrey E Gilliland,Jose A Vazquez,Zachary A Thompson,Carolina Granada

doi:10.1038/s41598-019-55703-9

Abstract

Persons infected with HIV are particularly vulnerable to a variety of oral microbial diseases. Although various study designs and detection approaches have been used to compare the oral microbiota of HIV-negative and HIV-positive persons, both with and without highly active antiretroviral therapy (HAART), methods have varied, and results have not been consistent or conclusive. The purpose of the present study was to compare the oral bacterial community composition in HIV-positive persons under HAART to an HIV-negative group using 16S rRNA gene sequence analysis. Extensive clinical data was collected, and efforts were made to balance the groups on clinical variables to minimize confounding. Multivariate analysis was used to assess the independent contribution of HIV status. Eighty-nine HIV-negative participants and 252 HIV-positive participants under HAART were sampled. The independent effect of HIV under HAART on the oral microbiome was statistically significant, but smaller than the effect of gingivitis, periodontal disease, smoking, caries, and other clinical variables. In conclusion, a multivariate comparison of a large sample of persons with HIV under HAART to an HIV-negative control group showed a complex set of clinical features that influenced oral bacterial community composition, including the presence of HIV under HAART.

Highlights

Persons infected with HIV are vulnerable to a variety of oral microbial diseases
Persons infected with HIV are vulnerable to a wide variety of oral diseases including gingivitis, periodontitis, dental caries, endodontic infections, oropharyngeal candidiasis (OPC), necrotizing ulcerative periodontitis, oral warts, oral hairy leukoplakia, and Kaposi’s sarcoma[1,2,3]
A significant independent effect of HIV treated with highly active antiretroviral therapy (HAART) on the oral microbiome was shown, but it was smaller than the effect of other clinical variables, including periodontal disease, smoking and caries

Summary

Introduction

Persons infected with HIV are vulnerable to a variety of oral microbial diseases. The largest differences have been observed between HIV-negative groups and untreated HIV-positive groups, with HAART tending to restore a microbiota closer to that of HIV-negative groups[5,15] Limitations of these studies variously include small sample sizes, targeted assays that survey only a small subset of the total bacterial community, approaches not capable of resolving at the species level, and lack of accounting for potential clinical confounders such as demographic or health factors. Care was taken to minimize potential confounders, and multivariate analysis was used to assess the independent contribution of HIV status Using this approach, a significant independent effect of HIV treated with HAART on the oral microbiome was shown, but it was smaller than the effect of other clinical variables, including periodontal disease, smoking and caries

Objectives

Methods

Results

Conclusion