Association between human herpes virus and aggressive periodontitis: A systematic review

Objectives: to elucidate the association between HHVs [Human Herpes Viruses–human cytomegalovirus (HCMV), Epstein–Barr virus (EBV) and herpes simplex virus (HSV)] and risk of aggressive periodontitis (AgP) and advanced periodontitis (AP). Materials and methods: the addressed focused question was: “Is there an association between HHVs and AgP and do HHVs implicate in the pathogenesis of AgP and AP?” Electronic search of the MEDLINE/PubMed, EMBASE, Scopus, ISI Web of knowledge, and Google-Scholar databases was combined with hand searching of articles published from 1970 up to and including March 2016 using relevant MeSH terms. Review papers, in-vitro and experimental studies, case reports, commentaries, interviews, updates and duplicate publications were excluded. Results: twelve studies were included. Three studies reported elevated percentage of HSV1 carriage in AgP patients whereas two studies reported comparable percentage levels of HSV1 among AgP patients and periodontally healthy patients. Seven studies reported significantly higher percentage levels of HCMV in AgP patients as compared to healthy controls whereas four studies showed comparable levels of HCMV among AgP and healthy controls. Six studies reported higher EBV carriage in AgP patients than healthy controls whereas five studies showed comparable EBV percentage levels among AgP and periodontally healthy patients. Conclusion: overall, human herpes virus (HSV, CMV and EBV) levels are increased and are found to be associated with AgP and AP as compared to healthy individuals. However a possible involvement of HHVs in the pathogenesis of AgP warrants further investigation.