Th1/Th2 cytokine profiles in saliva of HIV‐positive smokers with oropharyngeal candidiasis

Abstract

Oropharyngeal candidiasis (OPC) is a common opportunistic infection among HIV‐positive individuals and often correlates with a CD4 cell number < 200 cells/µl. This study further examined the association of smoking and OPC in HIV‐positive persons. A strong association between smoking and OPC was seen in HIV‐positive individuals with ≥ 200 CD4 cells/µl. In HIV‐positive persons with ≥ 200 CD4 cells/µl, OPC⁺ smokers had lower gamma‐interferon (IFN‐γ) concentrations and a trend toward higher interleukin (IL)‐4 concentrations in whole saliva compared to OPC^– persons with ≥ 200 CD4 cells/µl, a cytokine profile consistent with that observed in HIV⁺OPC⁺ persons with < 200 CD4 cells/µl. These results suggest that premature OPC in HIV‐positive smokers is associated with altered oral host defence mechanisms that cannot be overcome by levels of systemic CD4 cells that are otherwise sufficient to protect against OPC.