Leao J C, Porter S, Scully C
Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife PE, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Dec;90(6):694-704. doi: 10.1067/moe.2000.110036.
The purpose of this report was to review the current literature on human herpesvirus 8 (HHV-8) with particular attention to the aspects of interest for dental health care workers.
The authors searched original research and review articles on specific aspects of HHV-8 infection, including virology, epidemiology, transmission, diagnosis, natural history, therapy, and oral aspects. The relevant material was evaluated and reviewed.
HHV-8 is a recently discovered DNA virus that is present throughout the world but with major geographic variation. In the Western world, the virus, transmitted mainly by means of sexual contact, is strongly associated with Kaposi's sarcoma and body cavity-based lymphoma and more controversially with multiple myeloma and non-neoplastic disorders. There is no specific effective treatment, but human immunodeficiency virus protease inhibitors may play an indirect role in the clearance of HHV-8 DNA from peripheral blood mononuclear cells of patients infected with human immunodeficiency virus. HHV-8 DNA is present in saliva, but as yet, there are no documented instances of nosocomial transmission to health care workers. The prevalence of HHV-8 among dental health care workers is probably similar to that in the general population.
HHV-8 does not appear to be ubiquitous in most populations, particularly in western Europe and the United States, where it may be restricted to a population at risk of having Kaposi's sarcoma develop (men infected with human immunodeficiency virus and patients who are iatrogenically immunosuppressed). Most serologic studies suggest a global HHV-8 seroprevalence of 2% to 10% and show that the virus may be under immunologic control in people who are healthy but infected with HHV-8. Also, HHV-8 certainly has the means to overcome cellular control and immune responses and thus predispose to malignancy. To date, there are no data to suggest that health care staff members are at particular risk of HHV-8 acquisition through occupational routes.
本报告旨在回顾关于人类疱疹病毒8型(HHV-8)的当前文献,特别关注牙科医护人员感兴趣的方面。
作者检索了关于HHV-8感染特定方面的原始研究和综述文章,包括病毒学、流行病学、传播、诊断、自然史、治疗以及口腔方面。对相关材料进行了评估和综述。
HHV-8是一种最近发现的DNA病毒,在世界各地均有存在,但存在主要的地理差异。在西方世界,该病毒主要通过性接触传播,与卡波西肉瘤和体腔淋巴瘤密切相关,与多发性骨髓瘤和非肿瘤性疾病的关联则更具争议性。目前尚无特效治疗方法,但人类免疫缺陷病毒蛋白酶抑制剂可能在清除感染人类免疫缺陷病毒患者外周血单个核细胞中的HHV-8 DNA方面发挥间接作用。HHV-8 DNA存在于唾液中,但目前尚无医护人员发生医院感染传播的记录实例。牙科医护人员中HHV-8的流行率可能与普通人群相似。
在大多数人群中,HHV-8似乎并非普遍存在,尤其是在西欧和美国,它可能仅限于有患卡波西肉瘤风险的人群(感染人类免疫缺陷病毒的男性和医源性免疫抑制患者)。大多数血清学研究表明,全球HHV-8血清阳性率为2%至10%,并表明该病毒在健康但感染HHV-8的人群中可能受到免疫控制。此外,HHV-8肯定有办法克服细胞控制和免疫反应,从而易患恶性肿瘤。迄今为止,尚无数据表明医护人员通过职业途径感染HHV-8的风险特别高。