AIDS and Oral Manifestations of Immunosuppression Program
Infectious Diseases and Immunity Branch
Division of Basic and Translational Sciences
We are seeking Concept Clearance for a Request for Applications (RFA) that will encourage research to improve our understanding of the biological basis of development of AIDS-related oral cancers and tumors and which will encourage research identifying novel targets for treatment and biomarkers for early diagnosis as well as monitoring of disease progression.
The hallmark of HIV infection is a gradual depletion of CD 4+ T cells which eventually leads to a state of immunosuppression. This immunosuppression predisposes the patients to oral cancers, warts and preneoplastic oral lesions, many of which are aggressive, hard to treat and can markedly affect the quality of life of the patients.
The incidence of some of these conditions has changed following the introduction of highly active antiretroviral therapy (HAART). For example, the incidence of KS has significantly decreased, while another form of B cell lymphoma, plasmablastic lymphoma, has increased. The latter appears to be associated with Epstein Barr virus (EBV). Human papillomavirus (HPV), another DNA virus, has been associated with the development of oral warts and the incidence of these warts appears to be increasing in the HAART era. The incidence of salivary gland disease among HIV infected patients also appears to have increased following the introduction of HAART. These patients present with signs and symptoms similar to patients with Sjögren’s syndrome. The cause of this increase is not known at the present time. Occasionally, these patients may develop lymphomas within their salivary glands.
There appears to be an emerging role for various concurrent viral infections in the HIV-infected host that are likely implicated in the pathogenesis of AIDS-related oral malignancies and tumors. Applications examining these associations are of interest in regard to this RFA.
We anticipate that this initiative will stimulate new research to define the genetic, physiological, immunological and biochemical basis for the development of AIDS-related oral malignancies.