CHARACTERIZATION OF HIV-RELATED PERIODONTITIS IN AIDS PATIENTS - HIV-INFECTED MACROPHAGE EXUDATE IN GINGIVAL CREVICULAR FLUID AS A HALLMARKOF DISTINCTIVE ETIOLOGY

In an attempt to clarify the immunobiological events featuring periodo ntitis lesions of AIDS patients in the late stage of the disease, peri pheral blood (PB) and gingival crevicular fluid (GCF) leucocytes from periodontitis lesions of 23 late-stage AIDS patients were analysed by three-colour flow cytometry for detection and identification of intrac ytoplasmic p24(+) cell fractions. The cells were reacted with CD14 and CD68 for mononuclear phagocytes or with CD4 and CD14 for Th cells, th en with anti-p24 MoAb. To detect HIV proviral sequences and intracellu lar p24 RNA sequences, genomic DNA and cellular RNA from leucocytes we re extracted for semi-nested polymerase chain reaction (PCR) amplifica tion. CD68(+)/p24(+) and CD14(+)/CD68(+)/p24(+) fractions were larger in GCF than in PB (P < 0.0001; P < 0.003). CD14(+)/p24(+) fraction was lower in GCF than in PB (P < 0.05). The fluorescence intensities (FI) for intracellular p24 in CD68(+) and CD14(+)/CD68(+) cells were highe r in GCF than in PB (P < 0.003; P < 0.02), whereas those of CD14(+) ma crophages did not differ. The p24 FI of CD68(+) macrophages in GCF cor related with CD4(+) lymphocyte counts in PB (P < 0.005). p24 FI levels of CD14(+) monocytes in GCF and PB significantly correlated (P < 0.02 ), whereas that of CD68(+) macrophages did not. PCR and reverse transc riptase (RT)-PCR of cellular DNA and RNA yielded positive signals, dem onstrating viral integration and production in GCF leucocytes. These r esults show that periodontitis lesions in AIDS patients can be charact erized by a rapid macrophage turnover, and these HIV-infected macropha ge exudates in GCF may be considered as a within-mouth source of virus .