title: Mucosal shedding of human herpesvirus 8 in men.
abstract: BACKGROUND
  Epidemiologic studies suggest that human herpesvirus 8 (HHV-8) is sexually transmitted among men who have sex with men; however, the mode of transmission is unclear.
  
  
  METHODS
  To evaluate the patterns of shedding of HHV-8, we obtained mucosal-secretion samples from a cohort of HHV-8-seropositive men who had sex with men and had no clinical evidence of Kaposi's sarcoma. Quantitative polymerase-chain-reaction (PCR) assays, in situ PCR assays, and in situ RNA hybridization were used to identify potential sources of infectious HHV-8.
  
  
  RESULTS
  We detected HHV-8 in at least one mucosal sample from 30 of 50 men who were seropositive for HHV-8 (60 percent). Overall, HHV-8 was detected in 30 percent of oropharyngeal samples, as compared with 1 percent of anal and genital samples (P<0.001). In 39 percent of the HHV-8-seropositive men, HHV-8 was detected in saliva on more than 35 percent of the consecutive days on which samples were obtained. The median log titer of HHV-8 from the oral cavity was approximately 2.5 times as high as the titer at all other sites. In situ hybridization studies indicated that HHV-8 DNA and messenger RNA were present in oral epithelial cells. Among 92 men who had sex with men and who were seronegative for the human immunodeficiency virus (HIV), a history of sex with a partner who had Kaposi's sarcoma, deep kissing with an HIV-positive partner, and the use of amyl nitrite capsules ("poppers") or inhaled nitrites were independent risk factors for infection with HHV-8.
  
  
  CONCLUSIONS
  Oral exposure to infectious saliva is a potential risk factor for the acquisition of HHV-8 among men who have sex with men. Hence, currently recommended safer sex practices may not protect against HHV-8 infection.
authors.affiliation: Department of Medicine, University of Washington, Seattle, USA.
authors.forename: J
authors.initials: J
authors.lastname: Pauk
authors.forename: M L
authors.initials: ML
authors.lastname: Huang
authors.forename: S J
authors.initials: SJ
authors.lastname: Brodie
authors.forename: A
authors.initials: A
authors.lastname: Wald
authors.forename: D M
authors.initials: DM
authors.lastname: Koelle
authors.forename: T
authors.initials: T
authors.lastname: Schacker
authors.forename: C
authors.initials: C
authors.lastname: Celum
authors.forename: S
authors.initials: S
authors.lastname: Selke
authors.forename: L
authors.initials: L
authors.lastname: Corey
mesh_terms: D001003:Anal Canal / Q000821:virology; D000914:Antibodies, Viral / Q000097:blood; D015331:Cohort Studies; D004279:DNA, Viral / Q000302:isolation & purification; D018562:Disease Transmission, Infectious; D005837:Genitalia, Male / Q000821:virology; D006566:Herpesviridae Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000821:virology*; D015999:Multivariate Analysis; D009960:Oropharynx / Q000821:virology; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012463:Saliva / Q000821:virology*; D012514:Sarcoma, Kaposi / Q000209:etiology; D017201:Virus Shedding
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral