Human Herpesvirus‐8 Infection and Oral Shedding in Amerindian and Non‐Amerindian Populations in the Brazilian Amazon Region

Souza, Vanda Akico Ueda Fick de; Sumita, Laura Masami; Nascimento, M. C.; Oliveira, Juliane; Mascheretti, Melissa; Quiroga, Mariana; Freire, Wilton S.; Tateno, Adriana Fumie; Boulos, Marcos; Mayaud, Philippe; Pannuti, Cláudio Sérgio

doi:10.1086/520549

Cited by 55 publications

(79 citation statements)

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“…The HHV-8 whole-virus ELISA assay had the highest sensitivity, confirming previous reports [9,11,14], a moderate specificity, and a high NPV. The combination with IFA-LANA assay increased specificity without losing much on sensitivity and had the highest PPV to detect shedders.…”

Section: Discussionsupporting

confidence: 88%

“…Oral samples have been consistently shown to have the highest rates of HHV-8 viral detection compared to semen, urine, urethral, vaginal, and anal samples, suggesting that saliva may play an important role in HHV-8 transmission [2–9]. On the other hand, transmission through blood and blood transfusion remains a controversial issue with no conclusive evidence [10–12].…”

Section: Introductionmentioning

confidence: 99%

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Prospective study of human herpesvirus 8 oral shedding, viremia, and serological status among human immunodeficiency virus seropositive and seronegative individuals in Sao Paulo, Brazil

Braz‐Silva

Tozetto‐Mendoza

Sumita

et al. 2017

Journal of Oral Microbiology

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Human herpesvirus 8 (HHV-8) is a gamma-herpesvirus and etiological agent of all forms of Kaposi sarcoma (KS). Saliva may play an important role in HHV-8 transmission in specific populations. Little is known about HHV-8 oral shedding pattern and the possible correlation with the HHV-8 serological profile and viremia. A prospective study was conducted of HHV-8 salivary excretion among human immunodeficiency virus HIV-seronegative (n = 47) and -seropositive (n = 44) homosexual men and HIV-seropositive women (n = 32) over a 6-month period with monthly HHV-8 serologies (immunofluorescence assays to identify antibodies to latent and lytic HHV-8 viral proteins, and a whole-virus HHV-8 enzyme-linked immunosorbent assay [ELISA]), monthly HHV-8 DNA serum/plasma detection, and daily self-collected oral rinses for HHV-8-DNA detection using real-time polymerase chain reaction. HHV-8 seropositivity was 51.1%, 63.6%, and 37.5%, in the three studied groups. There was no case of HHV-8 DNA detection in serum/plasma. Intermittent detection of oral HHV-8 DNA was observed during 5.1% (110/2,160) of visits among 28% (18/64) of HHV-8-seropositive individuals, all of whom were males and HHV-8 ELISA seropositive. In immunologically controlled populations of Brazil, HHV-8 oral shedding was limited to HHV-8-seropositive men, occurred infrequently and intermittently, and was not linked to HHV-8 viremia, suggesting a limited potential for oral or blood transmission.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Prospective study of human herpesvirus 8 oral shedding, viremia, and serological status among human immunodeficiency virus seropositive and seronegative individuals in Sao Paulo, Brazil

Braz‐Silva

Tozetto‐Mendoza

Sumita

et al. 2017

Journal of Oral Microbiology

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“…HHV-8 seroprevalence in sub-Saharan Africa ranges from 40 to 70% in adults (6)(7)(8) while in Mediterranean countries is reported to be 16.5-18.7% (8). Interestingly, in Amerindian tribes HHV-8 is hyperendemic showing the highest infection rates ever reported (about 80% in adults) (9,10). In Uganda HHV-8 seroprevalence ranges from 26.6% in children to 40.1% in adults showing an age dependent increase during childhood (7,11,12).…”

Section: Introductionmentioning

confidence: 99%

Human herpesvirus 8 (HHV-8) salivary shedding in mothers and children from Uganda: risk factors and clues about transmission

Romano¹

2014

PER

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Background: in Africa, the increase of Kaposi Sarcoma-associated herpesvirus (KSHV/HHV-8) seroprevalence during childhood suggests an horizontal intrafamilial transmission. However, the exact transmission modes are yet unknown, but there is evidence that the virus is intermittently spread through the saliva of seropositive subjects. Furthermore, a significant correlation was found between the geographical distribution of bloodsucking arthropods and incidence rates of Kaposi Sarcoma. In this view, key roles can be played by: i) the inflammatory reaction due to the arthropod bites which create a micro-environment favourable to viral replication, and ii) the use of saliva as firstaid medication in several circumstances. According to that, the viral transmission could occur through the application of mothers' saliva on children's skin to relieve itching and scratching after a bloodsucking arthropod bite. This work investigated the risk factors involved in HHV-8 transmission based on the "promoter arthropod hypothesis". Methods: one hundred and thirty questionnaires were administered to Ugandan children (54 from settled and 76 from nomad communities) to evaluate the skin inflammatory reaction to the arthropod bites and the frequency of behavioural practices associated with saliva usage. At the same time saliva samples were collected from the children and respective mothers to detect the presence of HHV-8 DNA by Real-Time PCR. Results: we detected HHV-8 DNA in 23.85% of mothers and in 11.54% of children. The use of saliva is significantly more common in settled than in the nomad communities (p<0.001). The statistical analysis showed significant association between: i) skin inflammatory reaction and use of saliva in both groups; ii) environmental factors which increase the presence of bloodsucking arthropods and skin inflammatory reaction. Discussion: from our data we suppose that HHV-8 transmission could occur through non-sexual routes and that the infected saliva applied at child bite site could represent a favourable condition for the acquiring of the infection.

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“…KSHV seroprevalence is low (<5%) in most Western populations (1) and reaches 50% in some African populations (2), mirroring KS incidence rates (3). However, the highest KSHV seroprevalences worldwide (>80% in adults) have been reported in Amerindian tribes from the Amazon regions of Brazil (4,5) and Ecuador (6), despite the apparently low KS incidence in these populations (7). KSHV is thought to be transmitted through saliva between young siblings in disease-endemic areas such as French Guiana (8) or Africa (9), whereas sexual transmission in low-prevalence countries occurs within risk groups such as men who have sex with men (10).…”

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confidence: 99%

Seroprevalence of Kaposi Sarcoma–associated Herpesvirus and Other Serologic Markers in the Brazilian Amazon

Nascimento¹,

Sumita²,

Souza³

et al. 2009

Emerg. Infect. Dis.

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To determine the presence of Kaposi sarcoma-associated herpesvirus (KSHV) and other serologic markers, we tested serum specimens of 339 Amerindians, 181 rural nonAmerindians, and 1,133 urban blood donors (13 Amerindians) in the Brazilian Amazon. High KSHV seroprevalence in children and inverse association with herpes simplex virus type 2 indicates predominant nonsexual transmission among Amerindians. K aposi sarcoma-associated herpesvirus (KSHV) is the cause of Kaposi sarcoma (KS) and certain lymphoproliferative diseases (1). KSHV seroprevalence is low (<5%) in most Western populations (1) and reaches 50% in some African populations (2), mirroring KS incidence rates (3). However, the highest KSHV seroprevalences worldwide (>80% in adults) have been reported in Amerindian tribes from the Amazon regions of Brazil (4,5) and Ecuador (6), despite the apparently low KS incidence in these populations (7). KSHV is thought to be transmitted through saliva between young siblings in disease-endemic areas such as French Guiana (8) or Africa (9), whereas sexual transmission in low-prevalence countries occurs within risk groups such as men who have sex with men (10). Modes of transmission have not been clearly determined in Amerindian populations. The StudyWe conducted a cross-sectional study during February 2003-April 2004 to investigate the seroprevalence and factors associated with KSHV infection in Amerindian and non-Amerindian populations living in 2 regions of the Brazilian Amazon: a remote rural region of Para State (Mapuera, on the banks of the Trombetas River) and Manaus, the capital city of Amazonas State (Figure). Serologic markers of fecal-oral (hepatitis A virus [HAV]), blood-borne (hepatitis B and C viruses [HBV, HCV]) and sexually transmitted infections (Treponema pallidum [syphilis] and herpes simplex virus type 2 [HSV-2]) were used as proxies to identify possible routes of KSHV transmission in these populations.A convenience sample of unselected Amerindians and non-Amerindians living in the Mapuera area and a consecutive sample of nonpaid fi rst-time blood donors from the Manaus blood bank (HemoAm) consented to collection of blood samples, as previously reported (4,11) Ethical approval was obtained from the institutional review board of HemoAm, the ethical board of the Brazilian Ministry of Health, and the ethics committee of the London School of Hygiene and Tropical Medicine.In the absence of a defi nitive test to determine KSHV infection, all serum specimens were tested by using a previously validated in-house whole-virus KSHV ELISA (12) and 2 immunofl uorescence assays (IFAs) that detected antibodies against lytic (IFA-lytic) and latent-associated nuclear antigens (IFA-LANA) (12). KSHV infection was defi ned as positivity by any of these serologic assays. Serum specimens were also tested for the agent of syphilis by us- ing a T. pallidum-specifi c assay (Enzygnost Syphilis; Dade Behring, Marburg, Germany); for HSV-2 antibodies by using the type-specifi c HerpeSelect gG2 ELISA (Focus Technologies, Cypress H...

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Human Herpesvirus‐8 Infection and Oral Shedding in Amerindian and Non‐Amerindian Populations in the Brazilian Amazon Region

Abstract: The data support the hypothesis of early acquisition and horizontal transmission, via saliva, of HHV-8 subtype E in Amerindian populations.

Cited by 55 publications

References 49 publications

Prospective study of human herpesvirus 8 oral shedding, viremia, and serological status among human immunodeficiency virus seropositive and seronegative individuals in Sao Paulo, Brazil

Prospective study of human herpesvirus 8 oral shedding, viremia, and serological status among human immunodeficiency virus seropositive and seronegative individuals in Sao Paulo, Brazil

Human herpesvirus 8 (HHV-8) salivary shedding in mothers and children from Uganda: risk factors and clues about transmission

Seroprevalence of Kaposi Sarcoma–associated Herpesvirus and Other Serologic Markers in the Brazilian Amazon

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