Prevalence and Activity of Epstein-Barr Virus and Human Cytomegalovirus in Symptomatic and Asymptomatic Apical Periodontitis Lesions

Hernádi, Katinka; Szalmás, Anita; Mogyorósi, Richárd; Czompa, Levente; Veress, György; Csoma, Eszter; Márton, Ildikó; Kónya, József

doi:10.1016/j.joen.2010.06.008

« Previous Next »Journal of Endodontics
Volume 36, Issue 9 , Pages 1485-1489, September 2010

Prevalence and Activity of Epstein-Barr Virus and Human Cytomegalovirus in Symptomatic and Asymptomatic Apical Periodontitis Lesions

Katinka Hernádi, MD
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Anita Szalmás, MSc
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Richárd Mogyorósi, MD
- Faculty of Dentistry, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Levente Czompa, MD
- Faculty of Dentistry, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
György Veress, PhD
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Eszter Csoma, PhD
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Ildikó Márton, MD, PhD, DSci
- Faculty of Dentistry, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
József Kónya, MD, PhD
- Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Address requests for reprints to Dr J Kónya, PO Box 17 Debrecen 4012 Hungary.

Abstract

Introduction

Apical periodontitis is a polymicrobial inflammation with a dominant flora of opportunistic Gram-negative bacteria; however, a pathogenic role of human herpesviruses such as Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) has been implicated recently. The aims of this study were to determine the prevalence, activity, and disease association of EBV and HCMV in apical periodontitis in an Eastern Hungarian population.

Methods

Forty samples with apical periodontitis (17 symptomatic and 23 asymptomatic) and 40 healthy pulp controls were collected. EBV and HCMV prevalences were measured by polymerase chain reaction (PCR) detection of the viral DNA and viral activity was tested by reverse-transcription PCR amplification of viral messenger RNA.

Results

EBV DNA and EBNA-2 messenger RNA were found in apical periodontitis lesions at significantly (p < 0.0001) higher frequencies (72.5% and 50%, respectively) than in controls (both 2.5%). The occurrence of HCMV infection was rare in both apical lesions (10%) and controls (0%). The presence of EBV DNA in apical lesions was associated significantly with large (≥5 mm) lesion size (p = 0.02) but not with symtoms (p = 0.30). Symptomatic manifestation was significantly associated with the co-occurrence (odds ratio [OR], 8.80; 95% confidence interval [CI], 1.69-45.76) but not the sole occurrences of EBNA-2 messenger RNA (OR, 2.29; 95% CI, 0.48-11.06) and large lesion size (OR, 4.02; 95% CI, 0.81-19.89).

Conclusion

EBV infection is a frequent event in apical periodontitis, whereas the involvement of HCMV still remains to be elucidated. This study showed that symptomatic manifestation was likely to occur if a large-sized apical periodontitis lesion is aggravated with active EBV infection.

Key Words: Apical periodontitis, Epstein-Barr virus type III viral latency, herpesviruses, human cytomegalovirus, polymerase chain reaction