Seroprevalence of HHV-8 antibodies in HIV-positive homosexual men without Kaposi's sarcoma and their clinical follow-up.

Abstract

Human herpesvirus 8 (HHV-8) has been associated with Kaposi's sarcoma (KS). Because KS is most frequently seen in HIV-positive homosexual men, we retrospectively evaluated the seroprevalence of HHV-8 in this risk group and compared the clinical history and clinical course of the HHV-8-negative and HHV-8-positive groups. The study was performed by analyzing banked serum samples from asymptomatic HIV-positive men. HHV-8 seropositivity was determined by an indirect immunofluorescence test. A total of 56% of patients (42/75) were seropositive for anti-HHV-8 IgG antibodies as opposed to 12% of 40 age-matched HIV-negative controls. Median CD4 counts at study entry were significantly lower in the HHV-8-positive group than in the HHV-8-negative group (520 vs 686); however, the percentage decrease during a 30-month follow-up did not differ significantly. KS developed in two patients during follow-up; both were HHV-8-positive and had CD4 counts of less than 200/microL at the time of clinical manifestation. One HHV-8-positive patient in whom AIDS developed died of infectious complications. The longest follow-up in the HHV-8-positive cohort without development of KS was 81 months. We conclude that HHV-8 has a high seroprevalence in asymptomatic, homosexual, HIV-positive persons. An HHV-8 infection can precede the development of KS by many years. Immunosuppression below a certain threshold may trigger the clinical manifestation of KS.