HIV Infection and Human Herpesvirus-8 Oral Shedding Among Men Who Have Sex with Men

Abstract

Human herpesvirus-8 (HHV-8) is frequently detected in oropharyngeal secretions from HIV-infected men who have sex with men (MSM), and contact with saliva may be an important mode of HHV-8 transmission. A total of 196 MSM were followed over 2 years to determine the correlates of HHV-8 oropharyngeal shedding. A total of 134 (68%) of 196 participants were HHV-8 seropositive upon enrollment, and 9 (15%) of 62 participants seroconverted to HHV-8 during follow-up. HHV-8 DNA was detected in 43 (22%) of 196 participants: 39 (27%) of 134 HHV-8 seropositive, 4 (8%) of 53 HHV-8 seronegative, and 5 (56%) of 9 seroconverters to HHV-8. HHV-8 was detected in 101 (15%) of 696 total oral specimens: 84 (17%) of 481 samples from HHV-8-seropositive men, 6 (3%) of 180 samples from HHV-8-seronegative men, and 11 (31%) of 35 samples from seroconverters. Using adjusted marginal structural models, HHV-8 shedding was higher in men not receiving highly active antiretroviral therapy (odds ratio 2.4, 95% CI 1.0-6.0, P = 0.06), with CD4 counts > 200 cells/mm (odds ratio 4.8, 95% CI 1.0-22.8, P = 0.05), or with detectable oral leukocyte esterase (odds ratio 5.0, 95% CI 2.0-12.5, P < 0.01). CD4 count, antiretroviral therapy, and oral inflammation may influence HHV-8 oropharyngeal shedding.

Frequent and Asymptomatic Oropharyngeal Shedding of Human Herpesvirus 8 among Immunocompetent Men

“…It is interesting to note, however, that the frequency and quantity of HHV-8 shed from the oropharynx in these 2 individuals was lower than the median rates observed in MSM. The frequent and occasionally hightiter shedding of HHV-8 in this group of immunocompetent Seattle MSM, as well as of others that we have previously described [38], may help explain why nearly one-quarter of HIVnegative MSM in the United States and western Europe are infected with HHV-8 [39] and why HHV-8 appears to be an uncommon infection in the general population of these regions.…”

Activation of Kaposi's Sarcoma-Associated Herpesvirus Lytic Gene Expression during Epithelial Differentiation

“…Reference testing was performed by the Molecular Diagnostic Laboratory and the HPV Laboratory at the University of Washington using previously published methodology (5,9,43,97).…”

The HIV Protease Inhibitor Nelfinavir Inhibits Kaposi's Sarcoma-Associated Herpesvirus Replication In Vitro

“…There is precedent that ARVs may affect herpesvirus replication: zidovudine and stavudine have been shown to be substrates for the KSHV thymidine kinase (ORF21) (32) and therefore could directly inhibit KSHV replication, and ARVs have been shown to significantly reduce the detection of replicating KSHV in the oropharynx of HIV-infected men (10). To date, no comprehensive studies to test whether ARVs are able to inhibit KSHV viral production have been conducted (28,48).…”