2000, 3rd International KSHV Workshop

Scientific Presentations – 3rd International KSHV Workshop, University of Massachusetts at Amherst
July 6-10, 2000

Salivary Shedding of KSHV among Homosexual Men

Martin J, Lee T, Busch M, Cheng A, Graves A, Klencke B, Cossen C, Forghani B, Osmond D. UCSF, Blood Centers of the Pacific and CA Dept of Health Services

Background: Among bodily fluids that are readily passed between humans, saliva is most frequently found to contain KSHV and therefore may be an important conduit for KSHV transmission. Knowledge of the prevalence of KSHV salivary shedding among KSHV-infected homosexual men is currently limited to studies of small sample size, and little is known about the determinants of salivary shedding.

Methods: Homosexual men participating in the San Francisco Men’s Health Studies, a collection of population-based cohort studies which have been supplemented with KS patients, provided unstimulated whole saliva and blood. KSHV seropositivity was determined by an EIA containing whole virion lysate. The cell-free component of saliva was processed in parallel by the Qiagen QIAamp kit and by ultracentrifugation to obtain whole virion. KSHV was detected by PCR using KS1 and KS2 primers.

Results: Among 513 men examined, KSHV was detected in the saliva of 22% of 60 KS patients, 16% of 226 KSHV-seropositives without KS, and 0.9% of 227 KSHV-seronegatives. The median copy number was 107/ml by Quiagen and 120/ml by ultracentrifugation isolation. In a multivariable analysis among those KSHV-seropositive or with KS, KSHV-saliva-positivity was associated with HIV infection (OR=2.2, p=0.027), and recreational use of “poppers” (OR=2.0, p=0.049) and gammahydroxybutyric (GHB) (OR=2.5, p=0.031); alcohol use was protective (OR=0.5, p=0.040). In a sub-sample (n=92), PCR-positivity in blood cells was also associated with saliva-positivity (OR=7.6, p<0.01). Saliva-positivity was not associated with age, having KS, or use of acyclovir, cocaine, or speed, and in HIV-infected men was not associated with HIV viral load or CD4 cells.

Conclusion: KSHV is frequently found in the saliva of KSHV-infected homosexual men. That HIV infection increases shedding suggests that HIV may fuel the KS epidemic by increasing infectiousness in addition to hastening KS development in those who are KSHV-infected. If their roles are confirmed, the use of “poppers”, long associated with KS per se, and GHB may also be escalating the KS epidemic in homosexual men by increasing infectiousness and/or potentiating viral activity in infected men.

Last modified: November 2, 2012