Impact of HIV Infection and Kaposi Sarcoma on Human Herpesvirus-8 Mucosal Replication and Dissemination in Uganda
2009

Impact of HIV Infection and Kaposi Sarcoma on HHV-8 Replication in Uganda

Sample size: 78 publication 10 minutes Evidence: high

Author Information

Author(s): Johnston Christine, Orem Jackson, Okuku Fred, Kalinaki Mary, Saracino Misty, Katongole-Mbidde Edward, Sande Merle, Ronald Allan, McAdam Keith, Huang Meei-Li, Drolette Linda, Selke Stacy, Wald Anna, Corey Lawrence, Casper Corey

Primary Institution: University of Washington

Hypothesis

What role do the site, persistence, and quantity of HHV-8 replication play in the progression to Kaposi sarcoma?

Conclusion

HHV-8 detection is frequent in the oropharynx and peripheral blood of Ugandans with endemic and epidemic Kaposi sarcoma, with increased viremia in men and those with HIV.

Supporting Evidence

  • HHV-8 was detected more frequently in the oropharynx and peripheral blood of persons with KS compared to those without.
  • Oral HHV-8 detection predicted subsequent HHV-8 viremia.
  • HHV-8 viremia was significantly more common in men and those with HIV.

Takeaway

This study shows that a virus related to Kaposi sarcoma is often found in the mouths and blood of people in Uganda, especially those with HIV or Kaposi sarcoma.

Methodology

Participants collected oral swabs daily and clinicians collected oral, anogenital swabs, and plasma samples weekly over 4 weeks; HHV-8 DNA was quantified by PCR.

Potential Biases

Potential bias due to the exclusion of participants with lower CD4+ counts and those on antiviral medications.

Limitations

The study had a short follow-up period and included only participants with CD4+ T-cell counts greater than 200/mm3.

Participant Demographics

Median age was 32 (range 18–60); 50% of participants without KS were women.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 1.7–6.2

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0004222

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