Salivary lactoferrin in HIV-infected children: Correlation with Candida albicans carriage, oral manifestations, HIV infection and its antifungal activity

Objectives: This study aimed to evaluate the concentration of lactoferrin in the saliva of HIV infected and healthy children and analyze the associations between lactoferrin levels, Candida sp. colonization, oral manifestations and medical data. Also, the antifungal ability of lactoferrin to inhibit the growth of Candida albicans isolated from saliva of these children was investigated in vitro. Subjects and methods: Saliva was collected from 70 HIV-infected and 50 healthy children, followed by oral manifestation assessments. The salivary lactoferrin was quantified using an ELISA Kit (R). The salivary samples were cultured and the Candida spp. colonies counted and then identified by sugar assimilation and fermentation. The antifungal activity of lactoferrin was analyzed in vitro with 10 isolates of C. albicans from each group. Results: The HIV infected children (mean age 9.8 +/- 2.8) had higher lactoferrin levels (median 6.13 mu g/ml (3.58-7.89)) and were colonized three times more by Candida sp. than the control group (mean age 9.4 +/- 2.4) (median 5.74 mu g/ml (3.12-6.86)) (p = 0.003). Statistical associations were found considering the salivary lactoferrin levels and Candida sp. and oral manifestations between the groups. No associations between lactoferrin concentrations and oral manifestations, immunosuppression, presence of AIDS and use of HAART were observed in the HIV group. The percentage of dead C. albicans due to lactoferrin was inversely proportional to C. albicans cell density for both groups (p < 0.001). Conclusions: HIV-infected children have higher concentrations of lactoferrin and it was associated with Candida sp. colonization but no association with medical data was found. Also, both groups showed similar lactoferrin antifungal activity. (C) 2014 Published by Elsevier Ltd.