The presence of human herpesvirus 8 in patients with HIV was strongly associated with Kaposi sarcoma (odds ratio, 23.4; 95% CI, 7.7-71.4), male gender, homosexual or bisexual orientation, and hepatitis B virus infection, but not with the other sexually transmitted diseases that were investigated.
The aims of the present study were to determine the prevalence of human herpesvirus type 8 (HHV-8) in HIV-positive Brazilian patients with (HIV+/KS+) and without Kaposis sarcoma (HIV+/KS-) using PCR and immunofluorescence assays, to assess its association with KS disease, to evaluate the performance of these tests in detecting HHV-8 infection, and to investigate the association between anti-HHV-8 antibody titers, CD4 counts and staging of KS disease. Blood samples from 66 patients, 39 HIV+/KS+ and 27 HIV+/KS-, were analyzed for HHV-8 viremia in peripheral blood mononuclear cells by PCR and HHV-8 antigenemia for latent and lytic infection by immunofluorescence assay. Positive samples for latent nuclear HHV-8 antigen (LNA) antibodies were titrated out from 1/100 to 1/409,600 dilution. Clinical information was collected from medical records and risk behavior was assessed through an interview. HHV-8 DNA sequences were detected by PCR in 74.3% of KS+ patients and in 3.7% of KS-patients. Serological assays were similar in detecting anti-LNA antibodies and anti-lytic antigens in sera from KS+ patients (79.5%) and KS-patients (18.5%). HHV-8 was associated with KS whatever the method used, i.e., PCR (odds ratio (OR) = 7.4, 95% confidence interval (CI) = 2.16-25.61) or anti-LNA and anti-lytic antibodies (OR = 17.0, 95%CI = 4.91-59.14). Among KS+ patients, HHV-8 titration levels correlated positively with CD4 counts (rho 0.48, P = 0.02), but not with KS staging. HHV-8 is involved in the development of KS in different geographic areas worldwide, as it is in Brazil, where HHV-8 is more frequent among HIV+ patients. KS severity was associated with immunodeficiency, but no correlation was found between HHV-8 antibody titers and KS staging.
This study assessed the prevalence of and correlated factors for chronic hepatitis B infection (HBV) among HIV patients attending the Reference Center for Sexually Transmitted Infections (STI) and AIDS in Vitória, ES, Brazil. HIV patients were studied from 1993 to 2004, using information recorded in a database of the STI Clinic. Demographic data, clinical characteristics, patterns of risk behavior and test results (ELISA-HIV, IFA-HIV, HBsAg, viral load and CD4 counts) were analyzed. We analyzed 851 HIV patients. Median age was 35.0 (interquartile range 30; 42) years and median years of education was 8.0 (IQR 5; 11). The prevalence of chronic HBV was 3.8% (95% CI 2.5-5.1). Illicit drug use was reported in 185 (21.7%) cases, alcohol abuse in 80 (9.4%) cases, men who have sex with men in 116 (13.6%) cases, and past STI in 320 (37.6%) cases. Chronic HBV was associated with intravenous drug use, male gender, STI associated with HIV diagnosis, and death. There is a need for prevention and assistance strategies to control the evolution of this infection in HIV patients.
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