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HAART may reduce HHV-8 shedding in HIV-infected men
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By David Douglas
NEW YORK (Reuters Health) - Highly active antiretroviral therapy (HAART) appears to reduce oral shedding of human herpesvirus-8 (HHV-8) -- the virus associated with Kaposi's sarcoma -- in HIV-infected men who have sex with men (MSM), Seattle-based researchers report in the March 1st issue of the Journal of Acquired Immunodeficiency Syndromes.
As lead investigator Dr. Corey Casper told Reuters Health, "our study shows that nearly one quarter of HIV-infected MSM in Seattle have HHV-8 found in their saliva, especially those not on effective treatment for HIV."
Dr. Casper of the University of Washington and colleagues note that HHV-8 is frequently seen in oropharyngeal secretions from such men and that contact with saliva may be an important mode of transmission.
If this is the case, the team points out, understanding factors associated with "viral shedding may have important ramifications for prevention of disease."
To investigate, the researchers followed 196 MSM over a period of 2 years. In all, 134 (68%) were HHV-8 seropositive at enrollment and 9 (15%) of the remaining 62 subjects became seropositive during follow-up.
HHV-8 DNA was recovered more frequently from the oropharynx of men not receiving HAART (odds ratio 2.4). This was also true of those with CD4 cell counts below 200 per microliter (odds ratio 4.8) and subjects with detectable leukocyte esterase in the oropharynx (odds ratio 5.0).
Thus, should mucosal shedding be a risk factor for infectivity, the researchers point out that "our data imply that the use of HAART...could decrease HHV-8 transmission."
These findings, Dr. Casper added, "highlight the possible importance of the exposure to saliva and HIV infection in HHV-8 transmission, and may help to explain the epidemic rates of HHV-8 infection and Kaposi's sarcoma among HIV-infected men who have sex with men."
J Acquir Immune Defic Syndr 2004;35:233-238.
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