The gingival plasma cell infiltrate in HIV-positive patients with periodontitis is disorganized

Patients infected with the human immunodeficiency virus (HIV) are highly su sceptible to chronic marginal periodontitis (CMP) and the lesion is general ly characterized by abundant plasma cell infiltration. HIV-induced reductio n of CD4(+) T cells may indirectly affect local production of immunoglobuli ns (Ig). Gingival biopsies taken from 10 HIV+ and 12 HIV- control patients with CMP were washed, fixed in ethanol and embedded in paraffin. Sections w ere examined after immunohistochemical staining with monoclonal antibodies against IgA, IgA1-2, IgG, IgG1-4, IgM and IgE. Ig-containing cells were cou nted in 3 separate connective tissue zones (subjacent to pocket epithelium, central zone and subjacent to oral epithelium). HIV+ patients showed a rem arkably increased density of all Ig-containing cells in the connective tiss ue zone subjacent to the oral epithelium (p<0.05) and a lower % of IgG2(+) cells in the entire gingival section (p<0.05). In HIV+ patients, the densit y of IgG-containing cells in the gingiva was strongly correlated with the s erum IgG concentration. The altered topical distribution might imply impair ed restriction of the inflammatory lesion, additional antigenic challenges by unusual microorganism in the oral cavity, or be secondary to HIV-induced dysregulation of the B-cell system.