Human herpesvirus 8 shedding in the mouth and blood of hemodialysis patients

Abstract

In Saudi Arabia, the prevalence of transplantation‐associated Kaposi's sarcoma (KS) is high, and there is disparity in the prevalence rates of human herpesvirus 8 (HHV‐8) infection between patients with renal disease and the general population. It was hypothesized that oral HHV‐8 transmission among patients undergoing hemodialysis treatment contributes to the high prevalence of infection in renal disease patients. The detection rates of anti‐HHV8‐IgG in plasma and HHV‐8‐DNA in CD45(+)‐peripheral blood cells of 72 hemodialysis patients were compared first with those of 178 blood donors and 60 pregnant women. Between the hemodialysis patients and the apparently healthy people sampled, the detection rate of anti‐HHV‐8‐IgG was 16.7% versus 0.4% (P < 0.001) and that of HHV‐8‐DNA was 4.2% versus 0.4%, (P < 0.05). HHV‐8 DNA was determined in oral samples and the HHV‐8 viral load measured in saliva of patients undergoing hemodialysis. The amount of virus shed into saliva ranged between 8,600 and 119,562,500 (mean: 24,009,360) genome‐equivalents/ml among the five patients in whom oral HHV‐8 DNA was detected. Finally, HHV‐8‐subgenomic sequencing was conducted which showed that orally shed HHV‐8 in four patients belonged to genotype C2, and in one patient to genotypes A1 and C2. HHV‐8 shed in the mouth of hemodialysis patients may be extensive and diverse. Oral fluid in addition to blood is thus a likely vehicle for transmission of HHV‐8, possibly contributing to the high risk of HHV‐8 infection in patients undergoing hemodialysis and to KS following immunosuppression after renal transplantation. J. Med. Virol. 84:792–797, 2012. © 2012 Wiley Periodicals, Inc.

Seroprevalence of human herpesvirus 8 and its impact on the hemoglobin level in patients of end stage of renal diseases

“…In the present study, we found a relatively high prevalence of HHV8 (15.3%) among ESRD patients from eastern China and the prevalence was significantly lower in the comparison group (8.9%). The result is consistent with the previous reports that patients with uremia or hemodialysis had a high prevalence of HHV8 compared to healthy controls . The underlying causes of ESRD, the presence of the uremic status, as well as the application of dialysis, which may undermine the immune system of individual, were the potential risk factors for HHV8 infection in ESRD patients .…”

“…The result is consistent with the previous reports that patients with uremia or hemodialysis had a high prevalence of HHV8 compared to healthy controls. 11,12,26 The underlying causes of ESRD, the presence of the uremic status, as well as the application of dialysis, which may undermine the immune system of individual, were the potential risk factors for HHV8 infection in ESRD patients. 27 Furthermore, patients undergoing long-term ESRD are candidates for renal transplantation, a relatively high prevalence of HHV8 in ESRD patients with or without hemodialysis implies a high KS risk after transplantation.…”

“…6,7 HHV8 antibodies, however, were frequently detected before the initiation of immunosuppressive therapy, 8 indicating an early infection of HHV8 in patients with end-stage renal disease (ESRD). [9][10][11] A high prevalence of HHV8 was found in ESRD patients undergoing hemodialysis, 12,13 whom were candidates for renal transplantation and are usually under an immunodeficient state. [14][15][16] To a certain extent, HHV8 infection may increase the disease burden of ESRD patients and the risk for KS development after renal graft.…”

Tumor-specific changes in Kaposi sarcoma-associated herpesvirus genomes in Ugandan adults with Kaposi sarcoma

“…This exceedingly low intra-sample variation is within the published resolution of duplex sequencing [55]. While there are reports of intra-host KSHV variability in certain KSHV-endemic populations [38], in children [43], in iatrogenic settings [39–41] and in blood of AIDS-KS patients [42], these findings were arrived at by Sanger sequencing of PCR amplicon clones of hypervariable regions in K1 or other genes. Such protocols are more likely to detect errors that occurred during PCR.…”

Kaposi's Sarcoma in a Haemodialysis Patient: Case Report

“…Farklı çalış-malardan elde edilen ortak sonuç olarak; son dönem renal yetmezlikli hastalarda sağlıklı gruba göre artmış oranda seropozitivitenin olduğu göz-lemlenmiştir. [9][10][11] Bu sonuçla anlaşılan odur ki immünitesi baskılı hastalarda bu virüsle enfekte olunmakta, ancak her hastada malignite gelişme-mektedir. Yani, HHV-8 ile birebir Kaposi sarkomu ilişkisinden ziyade Kaposi sarkomu tanısı alan hastaların güçlü immünsüpresyon nedeni ile HHV-8 ile enfekte olmuş olma ihtimalleri daha yüksek gibi görünmektedir.…”