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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Impact of HIV infection and Kaposi Sarcoma on human herpesvirus-8 mucosal replication and dissemination in Uganda
PLoS ONE, Volume 4, No. 1, Article e4222, Year 2009
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Description
Introduction: Kaposi sarcoma (KS) is the leading cause of cancer in Uganda and occurs in people with and without HIV. Human herpesvirus-8 (HHV-8) replication is important both in transmission of HHV-8 and progression to KS. We characterized the sites and frequency of HHV-8 detection in Ugandans with and without HIV and KS. Methods: Participants were enrolled into one of four groups on the basis of HIV and-KS status (HIV negative/KS negative, HIV positive/KS negative, HIV negative/KS positive, and HIV positive/KS positive). Participants collected oral swabs daily and clinicians collected oral swabs, anogenital swabs, and plasma samples weekly over 4 weeks. HHV-8 DNA at each site was quantified by polymerase chain reaction (PCR). Results: 78 participants collected a total of 2063 orals swabs and 358 plasma samples. Of these, 428 (21%) oral swabs and 96 (27%) plasma samples had detectable HHV-8 DNA. HHV-8 was detected more frequently in both the oropharynx of persons with KS (24 (57%) of 42 persons with KS vs. 8 (22%) of 36 persons without, p = 0.002) and the peripheral blood (30 (71%) of 42 persons with KS vs. 8 (22%) of 36 persons without, p<0.001). In a multivariate model, HHV-8 viremia was more frequent among men (IRR = 3.3,95% CI = 1.7-6.2, p<0.001), persons with KS (IRR= 3.9, 95% CI = 1.7-9.0, p = 0.001) and persons with HIV infection (IRR = 1.7, 95% CI = 1.0-2.7, p = 0.03). Importantly, oral HHV-8 detection predicted the subsequent HHV-8 viremia. HHV-8 viremia was significantly more common when HHV-8 DNA was detected from the oropharynx during the week prior than when oral HHV-8 was not detected (RR = 3.3, 95% CI = 1.8-5.9 p<0.001). Genital HHV-8 detection was rare (9 (3%) of 272 swabs). Conclusions: HHV-8 detection is frequent in the oropharynx and peripheral blood of Ugandans with endemic and epidemic KS. Replication at these sites is highly correlated, and viremia is increased in men and those with HIV. The high incidence of HHV-8 replication at multiple anatomic sites may be an important factor leading to and sustaining the high prevalence of KS in Uganda. © 2009 Johnston et al.
Authors & Co-Authors
Johnston, Christine M.
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Orem, Jackson
Uganda, Kampala
Makerere University
Okuku, Fred Macho
Uganda, Kampala
Makerere University
Kalinaki, Mary
Uganda, Kampala
Makerere University
Saracino, Misty R.
United States, Seattle
University of Washington
Katongole-Mbidde, Edward
Uganda, Kampala
Makerere University
Uganda, Entebbe
Uganda Virus Research Institute
Sande, Merle A.
United States, Seattle
University of Washington
Uganda, Kampala
Makerere University
Uganda, Kampala
Academic Alliance for Aids Care and Prevention in Africa
Ronald, Allan R.
Uganda, Kampala
Makerere University
Uganda, Kampala
Academic Alliance for Aids Care and Prevention in Africa
McAdam, Keith P.W.J.
Uganda, Kampala
Makerere University
Huang, Meeili Wu
United States, Seattle
University of Washington
Drolette, Linda
United States, Seattle
University of Washington
Selke, Stacy
United States, Seattle
University of Washington
Wald, Anna
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Corey, Lawrence
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Casper, Corey
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Statistics
Citations: 55
Authors: 15
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0004222
e-ISSN:
19326203
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Uganda
Participants Gender
Male