Frequent and asymptomatic oropharyngeal shedding of human herpesvirus 8 among immunocompetent men

Abstract

Background: Little is known about the clinical and virologic manifestations of human herpesvirus (HHV)-8 infection in immunocompetent persons in the absence of malignancy.

Methods: A total of 46 human immunodeficiency virus-negative, HHV-8-seropositive men collected saliva daily, and 25 recorded 15 common symptoms daily (gastrointestinal, constitutional, and oropharyngeal) and absences from work or school. Quantitative polymerase chain reaction measured HHV-8 DNA in saliva.

Results: Some 44 (96%) of 46 men reported having sex with men (MSM). Of the 44 MSM, 27 (61%) had HHV-8 detected in saliva on > or = 1 day; heterosexual men also shed HHV-8. In analyses restricted to MSM, HHV-8 DNA was detected on 636 (22%) of 2897 days. Among MSM with HHV-8 detected in saliva, the median rate was 20% (range, 1%-100%), with 30% shedding on > 50% of days, and the median quantity was 4.5 log10 copies/mL (range, 2.0-7.3 log10 copies/mL). The quantity of HHV-8 shed was lower in nonwhites (P<.001) and younger participants (P=.03). The frequency of HHV-8 detection and quantity were correlated (r=0.62; P<.001). Symptoms were reported on 10 (9%) of 114 days when HHV-8 was present, compared with 78 (9%) of 830 days without (odds ratio, 0.93 [95% confidence interval, 0.30-2.88]; P=.9).

Conclusions: HHV-8 is detected frequently and intermittently in the saliva of chronically infected immunocompetent MSM, but this infection is asymptomatic.

Figure 1

Correlation between human herpesvirus (HHV)–8 shedding frequency and quantity among 27 participants with HHV-8 detected on at least 1 day. Solid line, fitted regression line.

Figure 2

Human herpesvirus (HHV)–8 oropharyngeal shedding frequency and quantity among immunocompetent men who have sex with men (MSM). Data from the first sampling session for each man are shown. Each row represents an individual subject. Within each row, each vertical bar depicts the quantity of HHV-8 DNA detected in 1 mL of saliva on a given day. Gray bars indicate days on which samples were either not collected or quantifiable, and colors are used to depict the quantity of HHV-8 DNA detected.