LSU DENTAL COBRE: ORAL PAPILOMAVIRUS IN THE HIV CO-INFECTED HOST

人类免疫缺陷病毒（HIV）已经感染了全世界超过3400万人，这种感染导致选择性消耗CD4 + T细胞的免疫抑制。这种免疫功能的下降导致许多乐观感染，超过50%的hiv感染者出现涉及口腔的病理。在导致口腔疾病的病原体中，粘膜萎缩性人乳头瘤病毒（HPV）是最常见的病毒性性传播疾病，也是粘膜疣和肛门生殖器恶性肿瘤的病因。HPV相关的口腔病变包括尖锐湿疣、局灶性上皮增生和一些鳞状细胞癌。HPV引起的口腔和生殖器病变更常见于合并感染艾滋病毒的患者。通过高活性抗逆转录病毒治疗（HAART）， HIV +患者完成了全身免疫重建，从而降低了死亡率、发病率以及全身和口腔机会性感染，包括hpv引起的宫颈病变的消退。矛盾的是，最近的报告注意到，在HAART治疗下，与HPV感染一致的口腔病理增加。如果这一观察结果能够得到证实，则表明宿主对口腔HPV感染的防御能力独立于HAART所恢复的防御能力，并可能受到不利影响。不幸的是,小

Human immunodeficiency virus (HIV) has infected over 34 million people worldwide and this infection leads to immune suppression with selective depletion of CD4 + T cells. This decrease in immune function leads to numerous oppommistic infections with over 50% of HIV-infected individuals developing pathology involving the oral cavity. Among the pathogens responsible for oral disease is the mucosatropic human Papilloma virus (HPV), which is the most common viral sexually transmitted disease and the etiologic agent of mucosal warts and anogenital malignancies. HPV associated oral lesions include condyloma, focal epithelial hyperplasia and some squamous cell carcinomas. Both oral and genital lesions caused by HPV are more commonly seen in those co-infected with HIV. Systemic immune reconstitution for the HIV + patient has been accomplished with highly active anti-retroviral therapy (HAART) leading to decreases in mortality, morbidity as well as systemic and oral opportunistic infections, including regression of HPV-induced cervical lesions. Paradoxically, recent reports have noticed increases in oral pathology consistent with HPV infection in the presence of HAART. If this observation can be confirmed, it suggests that the host defense against oral HPV infection is independent of that restored by HAART and may be adversely affected. Unfortunately, little is known about the natural history of HPV infection in the HIV-positive patient or the local immune dysfunction allowing the development of HPV oral lesions. We hypothesize that oral HPV infection and disease results from decreased oral-based immunity in the HIV co-infected individual that cannot be restored and is potentially reduced further by HAART. To begin to test this hypothesis, we will investigate the impact of effective HAART therapy on the progression of HPV infection and also the salivary immune response to the virus, followed by the characterization of the local immune response in those that develop HPV-related oral lesions. Results from this study will be evaluated for possible immunotherapeutic potential in the treatment of oral HPV infections.