Examining the long-term natural history of HHV-8 infection in humans

Corey Casper, MD, MPH, Anna Wald, MD, MPH, and Lawrence Corey, MD

 

1) HHV-8 Oropharyngeal Shedding Over Time.

After documenting the oral cavity as an important site of HHV-8 shedding and replication, we have begun to examine predictors of HHV-8 oropharyngeal shedding. We study HHV-8 mucosal shedding among a cohort of HIV-positive and HIV-negative persons in Seattle who collected daily oropharyngeal secretions for sessions ranging from 30 to 180 days. The large number of participants and samples collected will allow for the most detailed examination of HHV-8 oral shedding over time to be conducted to date.

2) Predictors of HHV-8 Oropharyngeal Shedding

A number of factors affect HHV-8 oropharyngeal shedding. Understanding these determinants may have important ramifications for the prevention of HHV-8 transmission and acquisition. We have documented a relationship between HIV infection and HHV-8 oropharyngeal shedding, and have preliminary evidence to suggest that antiviral medications may also influence the replication of HHV-8. Additional biologic, medical and behavioral predictors of HHV-8 shedding will be sought in the prospective study.

3) Anatomic Sites of HHV-8 Shedding

Over the past several years, more than 20,000 specimens from mucosal sites have been collected and submitted to the University of Washington Molecular Virology Laboratory for the quantification of HHV-8 DNA. We are currently in the process of analyzing these data to answer the following two questions: which mucosal sites most frequently shed HHV-8 DNA, and is there a correlation between shedding at disparate anatomic sites? Nearly 1000 persons who have had HHV-8 DNA detected at one or more anatomic site on the same day will be included in the first analysis of sites of viral shedding.