Pauk J, Huang M L, Brodie S J, Wald A, Koelle D M, Schacker T, Celum C, Selke S, Corey L
Department of Medicine, University of Washington, Seattle, USA.
N Engl J Med. 2000 Nov 9;343(19):1369-77. doi: 10.1056/NEJM200011093431904.
Epidemiologic studies suggest that human herpesvirus 8 (HHV-8) is sexually transmitted among men who have sex with men; however, the mode of transmission is unclear.
To evaluate the patterns of shedding of HHV-8, we obtained mucosal-secretion samples from a cohort of HHV-8-seropositive men who had sex with men and had no clinical evidence of Kaposi's sarcoma. Quantitative polymerase-chain-reaction (PCR) assays, in situ PCR assays, and in situ RNA hybridization were used to identify potential sources of infectious HHV-8.
We detected HHV-8 in at least one mucosal sample from 30 of 50 men who were seropositive for HHV-8 (60 percent). Overall, HHV-8 was detected in 30 percent of oropharyngeal samples, as compared with 1 percent of anal and genital samples (P<0.001). In 39 percent of the HHV-8-seropositive men, HHV-8 was detected in saliva on more than 35 percent of the consecutive days on which samples were obtained. The median log titer of HHV-8 from the oral cavity was approximately 2.5 times as high as the titer at all other sites. In situ hybridization studies indicated that HHV-8 DNA and messenger RNA were present in oral epithelial cells. Among 92 men who had sex with men and who were seronegative for the human immunodeficiency virus (HIV), a history of sex with a partner who had Kaposi's sarcoma, deep kissing with an HIV-positive partner, and the use of amyl nitrite capsules ("poppers") or inhaled nitrites were independent risk factors for infection with HHV-8.
Oral exposure to infectious saliva is a potential risk factor for the acquisition of HHV-8 among men who have sex with men. Hence, currently recommended safer sex practices may not protect against HHV-8 infection.
流行病学研究表明，人类疱疹病毒8型（HHV - 8）在男男性行为者中通过性传播；然而，传播方式尚不清楚。
为了评估HHV - 8的脱落模式，我们从一组HHV - 8血清学阳性、男男性行为且无卡波西肉瘤临床证据的男性中获取了黏膜分泌物样本。采用定量聚合酶链反应（PCR）检测、原位PCR检测和原位RNA杂交来鉴定传染性HHV - 8的潜在来源。
在50名HHV - 8血清学阳性男性中，有30名（60%）至少在一份黏膜样本中检测到HHV - 8。总体而言，30%的口咽样本中检测到HHV - 8，而肛门和生殖器样本中这一比例为1%（P<0.001）。在39%的HHV - 8血清学阳性男性中，在获取样本的连续35%以上天数的唾液中检测到HHV - 8。口腔中HHV - 8的中位对数滴度约为所有其他部位滴度的2.5倍。原位杂交研究表明，HHV - 8 DNA和信使RNA存在于口腔上皮细胞中。在92名男男性行为且人类免疫缺陷病毒（HIV）血清学阴性的男性中，与患有卡波西肉瘤的伴侣发生性行为史、与HIV阳性伴侣深吻以及使用亚硝酸戊酯胶囊（“Poppers”）或吸入亚硝酸盐是感染HHV - 8的独立危险因素。
经口接触传染性唾液是男男性行为者感染HHV - 8的一个潜在危险因素。因此，目前推荐的安全性行为可能无法预防HHV - 8感染。
