title: Oral HHV-8 replication among women in Mombasa, Kenya.
abstract: Human herpesvirus-8 (HHV-8) replication in the oropharynx may play an important role in HHV-8 transmission and contribute to the development of Kaposi sarcoma (KS) in some individuals. Studies in the United States and Europe report high rates of HHV-8 DNA detection in saliva of HHV-8 infected men, but little is known about the natural history of HHV-8 among persons in sub-Saharan Africa, where prevalence of HHV-8 infection and KS is greatest. To address this gap, this study evaluated oral HHV-8 replication in a cohort of 40 HHV-8 seropositive Kenyan women. Study clinicians collected daily oral swabs from participants for up to 30 consecutive days, and swab samples were tested for HHV-8 DNA using quantitative, real-time polymerase chain reaction. HHV-8 was detected at least once in 27 (68%) participants, and the overall shedding rate was 23%. On days with HHV-8 detection, mean HHV-8 quantity was 4.5 log10  copies/ml. Among HIV-infected women, CD4 count ≥500 cells/mm(3) versus <500 cells/mm(3) was associated with higher HHV-8 copy number (4.8 log10  copies/ml vs. 3.4 log10  copies/ml; coef 1.2 [95% CI, 0.5-1.9]; P = 0.001) and a higher HHV-8 shedding rate (49% vs.12%; RR, 4.2 [95% CI, 0.8-21.4]; P = 0.08). No other factors were associated with HHV-8 shedding rate or copy number. The study demonstrates high rates and quantity of HHV-8 in the oropharynx of HHV-8 seropositive African women. These findings support the observation that oral replication is an essential feature of HHV-8 infection, with likely implications for HHV-8 transmission and KS pathogenesis.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Warren
authors.initials: W
authors.lastname: Phipps
authors.forename: Misty
authors.initials: M
authors.lastname: Saracino
authors.forename: Stacy
authors.initials: S
authors.lastname: Selke
authors.forename: Meei-Li
authors.initials: ML
authors.lastname: Huang
authors.forename: Walter
authors.initials: W
authors.lastname: Jaoko
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
authors.forename: Corey
authors.initials: C
authors.lastname: Casper
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology; D006566:Herpesviridae Infections / Q000453:epidemiology*; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008875:Middle Aged; D009061:Mouth Mucosa / Q000821:virology*; D015995:Prevalence; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D019562:Viral Load; D017201:Virus Shedding
chemical_list: D004279:DNA, Viral
keywords: HIV-1; Kaposi sarcoma; Kaposi sarcoma-associated herpesvirus; human herpesvirus 8; viral replication