Repeated measures study of human herpesvirus 8 (HHV-8) DNA and antibodies in men seropositive for both HHV-8 and HIV.
OBJECTIVE
To study the natural history and pathogenesis of human herpesvirus 8 (HHV-8) infection in HHV-8-seropositive, immunosuppressed men.


METHODS
Longitudinal study of 87 HHV-8- and HIV-seropositive men [42 with Kaposi's sarcoma (KS)] during four visits over a 2 month period.


METHODS
: Patients provided oral fluid and blood. HHV-8 antibody titers were measured with peptide-based enzyme-linked immunosorbent assays (ELISA) for ORF65 and K8.1; HHV-8 DNA was detected with polymerase chain reaction ELISA.


RESULTS
HHV-8 DNA was present in oral fluid or peripheral blood mononuclear cells (PBMC) at one or more of the four visits in 71% of men with KS and 56% of men without KS. The strongest correlate of HHV-8 DNA in PBMC was the presence of KS [odds ratio (OR), 8.7; 95% confidence interval (CI), 3.4-22]. Detection of HHV-8 DNA in oral fluid or PBMC was often intermittent, but individuals who shed virus at one time point were more likely to shed at other times. Some men had incomplete epitope recognition in their anti-HHV-8 antibody response. High antibody titers were associated with the absence of circulating HHV-8, particularly for the ORF65 seroassay (OR, 0.16; 95% CI, 0.05-0.51).


CONCLUSIONS
Among HHV-8 seropositive men, circulating virus is common even in the absence of disease. The link between KS and HHV-8 DNA in PBMC suggests that anti-herpes drugs may impede KS development or progression. Seroassays should target multiple epitopes to achieve maximal sensitivity. HHV-8 replication may be limited by high antibody titers or other immune function for which antibodies are a marker.
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Rollins School of Public Health, Atlanta, Georgia 30333, USA.
A Scott
AS
Laney
Sheila C
SC
Dollard
Harold W
HW
Jaffe
Margaret K
MK
Offermann
Thomas J
TJ
Spira
Clifford J
CJ
Gunthel
Philip E
PE
Pellett
Michael J
MJ
Cannon
D000328:Adult; D000914:Antibodies, Viral / Q000302:isolation & purification*; D001826:Body Fluids / Q000821:virology; D004279:DNA, Viral / Q000302:isolation & purification*; D004797:Enzyme-Linked Immunosorbent Assay; D006679:HIV Seropositivity / Q000097:blood / Q000276:immunology*; D019288:Herpesvirus 8, Human / Q000235:genetics / Q000302:isolation & purification*; D018451:Homosexuality, Male; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology*; D008137:Longitudinal Studies; D008297:Male; D012514:Sarcoma, Kaposi / Q000097:blood / Q000209:etiology* / Q000276:immunology
D000914:Antibodies, Viral; D004279:DNA, Viral