Objective: This clinical and immunocytochemical study evaluated latent Epstein-Barr virus (EBV) in inflamed gingiva adherent to extracted carious teeth from Romanian orphans with and without HIV infection, and determined if antiretroviral therapy (ART) was related to latent EBV infection. Methods: The study population consisted of a convenience sample of 24 HIV-positive children (mean age 11.6 yr; 1.0M:1.0F) with 58% receiving ART, and 15 HIV-negative children (mean age 12.2 yr; 1.5M:1.0F), following approval by the Committee on the Protection of Human Subjects. Adherent gingival tissues were removed from teeth extracted due to nonrestorable carious lesions, and fixed in 10% buffered formalin. The tissues were routinely processed and embedded in paraffin for histopathologic and immunocytochemical evaluation. EBV latent membrane protein 1 (LMP1) was performed using a commercially available antibody (Novocastra) with antigen retrieval. This antibody reacts with cytoplasmic antigens associated with latent EBV infection. EBV-LMP1 expression was determined by 2 investigators, who were blinded to the HIV status of the children. Data were analyzed for EBV-LMP1 expression, and the relationship between ART and EBV-LMP1 using Fischer's exact test (2-tailed). Results: EBV-LMP1 was detected in 75% of HIV-positive orphans and in 47% of HIV-negative orphans (p=0.095). In the HIV-positive orphan population, ART medications did not influence EBV-LMP1 expression in the gingival tissues (p=0.192). EBV-LMP1 was identified in 86% of HIV-positive orphans receiving ART and in 60% of HIV-positive orphans not receiving ART. Conclusions: Evidence for latent EBV infection was identified in both HIV-positive and HIV-negative Romanian orphans. HIV infection did not increase the likelihood of latent EBV infection. Likewise, EBV latent infection occurs in a similar proportion of HIV-infected children with or without ART therapy. The EBV latent infection rate in Romanian orphans is similar to that reported for HIV-negative adults with active periodontal disease. (NIH/NIDCR T35DE07252-09).

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