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Prevalence of Human Herpesvirus-8 Salivary Shedding in HIV Increases with CD4 Count

¹ University of California, San Francisco (UCSF), 405 Irving Street, 2nd floor, San Francisco, CA 94122, USA;
² School of Medicine, University of Washington, Seattle, USA;
³ School of Medicine, University of California, San Francisco, USA;
⁴ School of Dentistry, University of California, San Francisco, USA;
⁵ School of Dentistry, University of Southern California, Los Angeles, USA; and
⁶ Lincoln Medical & Mental Health Center, Bronx, NY, USA;

^* corresponding author, mgandhi{at}itsa.ucsf.edu

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/µL 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.

KEY WORDS: HHV-8 • Kaposi’s sarcoma • HIV • salivary shedding • CD4 count

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