Knights Sheena M, Salyards Maverick, Kendall Noelle, Lazarte Susana M, Kainthla Radhika, Miley Wendell, Marshall Vickie, Labo Nazzarena, Whitby Denise, Chiao Elizabeth Y, Nijhawan Ank E
Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Internal Medicine, Parkland Health, Dallas, Texas, USA.
Open Forum Infect Dis. 2023 Mar 24;10(4):ofad160. doi: 10.1093/ofid/ofad160. eCollection 2023 Apr.
Disparities in mortality in human immunodeficiency virus (HIV)-associated Kaposi sarcoma have been described, particularly in Black men in the southern United States. It is unclear if there are racial/ethnic differences in the seroprevalence of Kaposi sarcoma-associated herpesvirus (KSHV) that may be contributing.
This is a cross-sectional study of men who have sex with men (MSM) and transgender women with HIV. Participants were recruited from an outpatient HIV clinic in Dallas, Texas, for a 1-time study visit and were excluded from analysis if they had any history of KSHV disease. Plasma was tested for antibodies to KSHV K8.1 or ORF73 antigens, and KSHV DNA was measured in oral fluids and blood by polymerase chain reaction. KSHV seroprevalence and viral shedding in blood and oral fluids were calculated. Additionally, independent risk factors for KSHV seropositivity were assessed by multivariable logistic regression analysis.
Two hundred five participants were included in our analysis. Overall, KSHV seroprevalence was high (68%) with no significant difference between racial/ethnic groups. Among seropositive participants, KSHV DNA was detected in 28.6% of oral fluids and 10.9% of peripheral blood specimens, respectively. The factors most strongly associated with KSHV seropositivity were oral-anal sex (odds ratio [OR], 3.02), oral-penile sex (OR, 4.63), and methamphetamine use (OR, 4.67).
High local seroprevalence of KSHV is likely a key driver of the high burden of KSHV-associated diseases regionally, though it does not explain the observed disparities in KSHV-associated disease prevalence among racial/ethnic groups. Our findings support that KSHV is primarily transmitted via exchange of oral fluids.
已描述了人类免疫缺陷病毒（HIV）相关卡波西肉瘤死亡率的差异，尤其是在美国南部的黑人男性中。尚不清楚卡波西肉瘤相关疱疹病毒（KSHV）的血清阳性率是否存在种族/民族差异，这可能是导致差异的原因。
这是一项对男男性行为者（MSM）和感染HIV的跨性别女性的横断面研究。参与者从得克萨斯州达拉斯的一家门诊HIV诊所招募，进行一次研究访问，如果他们有任何KSHV疾病史，则被排除在分析之外。检测血浆中针对KSHV K8.1或ORF73抗原的抗体，并通过聚合酶链反应在口腔液和血液中测量KSHV DNA。计算KSHV血清阳性率以及血液和口腔液中的病毒脱落情况。此外，通过多变量逻辑回归分析评估KSHV血清阳性的独立危险因素。
205名参与者纳入我们的分析。总体而言，KSHV血清阳性率很高（68%），种族/民族群体之间无显著差异。在血清阳性参与者中，分别在28.6%的口腔液和10.9%的外周血标本中检测到KSHV DNA。与KSHV血清阳性最密切相关的因素是口交-肛交（比值比[OR]，3.02）、口交-阴茎交（OR，4.63）和使用甲基苯丙胺（OR，4.67）。
KSHV在当地的高血清阳性率可能是该地区KSHV相关疾病高负担的关键驱动因素，尽管它无法解释在种族/民族群体中观察到的KSHV相关疾病患病率差异。我们的研究结果支持KSHV主要通过口腔液交换传播。
