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

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 bodily fluids) in 66 HIV and HHV-8 coinfected women without KS to 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 was 63 times the odds of shedding at CD4(95%CI 1.3-3078), with an increase in effect size when the analysis was restricted to those with a CD4 nadir>200. This data suggests an increased potential for HHV-8 transmission early in HIV infection, with implications for HHV-8 prevention