Epidemiology of HHV-8 infection in HIV-positive patients with and without Kaposi sarcoma: diagnostic relevance of serology and PCR.
BACKGROUND
Kaposi's sarcoma (KS) remains the most common neoplasm in HIV-infected patients. Human herpesvirus 8 (HHV-8) infection is etiologically associated with KS. Diagnostic procedures with regard to HHV-8 infection are not routinely performed in HIV-infected patients; diagnostic and prognostic value of HHV-8 serology or PCR are unknown in this setting. Epidemiological data concerning HHV-8 infection of HIV-infected patients in Germany are rare.


OBJECTIVE
To assess prevalence of HHV-8 infection in a cohort of HIV-infected patients with and without KS in Germany and to correlate this to manifestations and clinical course of KS.


METHODS
HHV-8 serology was performed in 483 patients in routine care for HIV-infection in northern Germany. HHV-8 DNA was analyzed by PCR in peripheral blood mononuclear cells (PBMC) of 293 patients; in a subgroup multiple samples were analyzed. History and manifestations of KS were recorded.


RESULTS
HHV-8 antibodies were detected using IFT in 91% of 33 patients with KS and 52% of 398 patients without KS. In 36 of 293 (12.3%) patients HHV-8 DNA was detected in PBMC. In general, HHV-8 DNA was not continuously detected when multiple samples from the same patient were analyzed. Patients with KS history were more likely to be PCR positive than those without (45.5% versus 7.8%). In patients with active KS HHV-8 DNA was detected more frequently than in patients with disease remission. HHV-8 DNA was not detected in serologically negative patients. However, three patients with KS history in full remission for several years were seronegative.


CONCLUSIONS
HIV-infected patients were frequently found to be positive for HHV-8 antibodies. The number of patients positive for viral DNA in PBMC was much smaller. Single PCR-examinations were of little value for prognosis, but repeated detection of HHV-8 DNA represents an increased risk of disease activity.
Albrecht
Dirk
D
ifi-Institut für interdisziplinaere Infektiologie und Immunologie, ifi-Medizin GmbH, im Allgemeinen Krankenhaus St. Georg, Hamburg, Germany. dalbrecht@fz-borstel.de
Meyer
Thomas
T
Lorenzen
Thore
T
Stoehr
Albrecht
A
Arndt
Ruediger
R
Plettenberg
Andreas
A
D001483:Base Sequence; D017931:DNA Primers; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005858:Germany / Q000453:epidemiology; D006679:HIV Seropositivity / Q000097:blood; D006566:Herpesviridae Infections / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D019288:Herpesvirus 8, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D015203:Reproducibility of Results; D012514:Sarcoma, Kaposi / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D012698:Serologic Tests / Q000379:methods
D017931:DNA Primers; D004279:DNA, Viral