Prevalence of human herpesvirus-8 salivary shedding in HIV increases with CD4 count.
Human herpesvirus-8 (HHV-8) is the etiologic agent of Kaposi's sarcoma (KS), which occurs in epidemic form in human immunodeficiency virus(HIV)-infected individuals. Saliva is the only mucosal fluid in which infectious HHV-8 has been identified, although factors associated with HHV-8 salivary shedding remain unclear. Our study performed PCR analysis for HHV-8 DNA in saliva (and other body fluids) in 66 HIV- and HHV-8-co-infected women without KS so that we could examine predictors for HHV-8 DNA detection. CD4 count was the most significant predictor of HHV-8 salivary shedding, with increased prevalence of HHV-8 salivary DNA at higher CD4 counts. The odds of salivary HHV8 shedding at CD4 counts > = 350 cells/microL was 63 times the odds of shedding at CD4 < 350 (95%CI, 1.3-3078), with an increase in effect size when the analysis was restricted to those with a CD4 nadir > 200. Analysis of these data suggests an increased potential for HHV-8 transmission early in HIV infection, with implications for HHV-8 prevention.
Gandhi
M
M
University of California, San Francisco (UCSF), 405 Irving Street, 2nd floor, San Francisco, CA 94122, USA. mgandhi@itsa.ucsf.edu
Koelle
D M
DM
Ameli
N
N
Bacchetti
P
P
Greenspan
J S
JS
Navazesh
M
M
Anastos
K
K
Greenblatt
R M
RM
D019380:Anti-HIV Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active; D001826:Body Fluids / Q000821:virology; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D006566:Herpesviridae Infections / Q000150:complications / Q000276:immunology* / Q000517:prevention & control / Q000821:virology*; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D011237:Predictive Value of Tests; D012463:Saliva / Q000821:virology*; D012514:Sarcoma, Kaposi / Q000821:virology; D012720:Severity of Illness Index; D017201:Virus Shedding
D019380:Anti-HIV Agents; D004279:DNA, Viral