Human Herpesvirus 8:  Epidemiology and Natural History

Lawrence Corey, MD

Project 4.  Epidemiology of Human Herpesvirus 8 (HHV-8)

Human Herpesvirus 8 (HHV-8), the newly characterized g -herpesvirus, is an important cause of morbidity and mortality in human immunodeficiency virus (HIV) infection. The virus is present in all forms of Kaposi's sarcoma (KS) and has also been implicated in the pathogenesis of multicentric Castleman's disease and body cavity based lymphoma. Seroepidemiologic studies have identified a relatively high prevalence of antibodies to HHV-8 among HIV-infected and uninfected men who have sex with men (MSM), heterosexually active adults, and across many age groups in the Italian and African populations. In the United States, the pattern of HHV-8 antibody positivity is most consistent with that of sexually transmitted infection, albeit mostly limited to MSM. In contrast, the serologic data from Africa and Italy suggest that HHV-8 may be acquired by other means, as the prevalence of infection rises in childhood and early adolescence. The mode of HHV-8 transmission may vary, therefore, in different populations. This is common with other herpesviruses. As HHV-8 has been identified in saliva, genital secretions, and blood, the exact mechanisms by which person to person transmission occurs is unclear.

Project 4 consists of 3 specific aims:

Specific Aim 1: To determine the prevalence and incidence of HHV-8 and the biologic and behavior risk factors for acquisition of HHV-8 among high risk cohorts.

Specific Aim 2: To characterize the clinical and virologic manifestations of primary HHV-8 infection

Specific Aim 3: To determine the most likely reservoir of infectious virus and the mode of transmission of HHV-8.

Recent Peer Reviewed Publications:

•  Casper, C., and L. Corey. 2002. Disease associations, diagnosis, and treatment of human herpesvirus 8. In B. Rose (ed.), UpToDate. UpToDate, Wellesley, MA.

•  Casper, C., and L. Corey. 2002. Virology and epidemiology of human herpesvirus 8. In B. Rose (ed.), UpToDate. UpToDate, Wellesley, MA.

•  Casper, C., E. Kexel, H. Taylor, J. Dalessio, D. Carrell, A. Wald, L. Corey, and R. L. Ashley. 2002. Assessment of a Combined Testing Strategy for the Detection of Antibodies to Human Herpesvirus 8 (HHV-8) in Persons with Kaposi's Sarcoma, Asymptomatic HHV-8 Infection, and at Low Risk for HHV-8 Infection. J Clin Microbiol in press.

•  Casper, C., M. Redman, M. L. Huang, H. Taylor, J. Pauk, T. Lampinen, S. E. Hawes, R. L. Ashley, L. Corey, N. B. Kiviat, and A. Wald. 2002. HIV Infection and Human Herpesvirus 8 (HHV-8) Oral Shedding Among Men Who Have Sex with Men. In Preparation.

•  Casper, C., A. Wald, J. Pauk, S. R. Tabet, L. Corey, and C. Celum. 2002. Correlates of Prevalent and Incident Kaposi's Sarcoma-Associated Herpesvirus Infection in Men Who Have Sex with Men. J Infect Dis 185:990-3.

•  Corey, L., S. Brodie, M. L. Huang, D. M. Koelle, and A. Wald. 2002. HHV-8 infection: a model for reactivation and transmission. Rev Med Virol 12:47-63.

•  Corey, L., J. Pauk, and A. Wald. 2001. Mucosal Shedding of Human Herpesvirus 8. N Engl J Med 344:691-692.

•  Diamond, C., S. J. Brodie, J. N. Krieger, M. L. Huang, D. M. Koelle, K. Diem, D. Muthui, and L. Corey. 1998. Human herpesvirus 8 in the prostate glands of men with Kaposi's sarcoma. J Virol 72:6223-7.

•  Diamond, C., H. Thiede, T. Perdue, D. MacKellar, L. A. Valleroy, and L. Corey. 2001. Seroepidemiology of human herpesvirus 8 among young men who have sex with men. Sex Transm Dis 28:176-83.

• Greenblatt, R. M., L. P. Jacobson, A. M. Levine, S. Melnick, K. Anastos, M. Cohen, J. DeHovitz, M. A. Young, D. Burns, P. Miotti, and D. M. Koelle. 2001. Human herpesvirus 8 infection and Kaposi's sarcoma among human immunodeficiency virus-infected and -uninfected women. J Infect Dis 183:1130-4.

•  Pauk, J., M. L. Huang, S. J. Brodie, A. Wald, D. M. Koelle, T. Schacker, C. Celum, S. Selke, and L. Corey. 2000. Mucosal Shedding of Human Herpesvirus 8 in Men. N Engl J Med 343:1369-1377.

•  Vieira, J., P. O'Hearn, L. Kimball, B. Chandran, and L. Corey. 2001. Activation of Kaposi's sarcoma-associated herpesvirus (human herpesvirus 8) lytic replication by human cytomegalovirus. J Virol 75:1378-86.