Taylor MM, The Journal of Infectious Diseases 2004; 190:484–8

Manifestazioni cliniche in 81 bambini correlate con i risultati del test serologico e

della PCR per HHV8

Dati cliniciResultati di IFA e PCR per HHV8 (%)

Ab - / PCR + (n=6)

Ab + / PCR + (n=14)

Ab + / PCR - (n=17)

Ab - / PCR - (n=44)

esantema 5 (83.3)* 2 (14.3) 3 (17.6) 5 (11.3)

tosse 2 (33.3) 5 (35.7) 7 (44.1) 17 (38.6)

angina 5 (83.3) 13 (92.8) 16 (94.1) 40 (90.9)

linfoadenopatia

0 7 (50) 13 (76.5) 32 (72.7)

diarrea 1 (16.6) 2 (14.3) 4 (23.6) 13 (29.5)

convulsioni 1 (16.6) 1 (7.2) 1 (5.9) 6 (13.6)

ulcere orali dolorose

0 2 (14.3) 4 (23.6) 8 (18.2)

altro 0 0 2 (11.8) 2 (4.5)

*p= 0.016

3/3 casi sieroconversione a 6 mesi

Andreoni JAMA. 2002 Mar 13;287(10):1295-300

Sarcoma di Kaposi

Sarcoma di Kaposi orale e polmonare

CoinfezioneHIV-HHV8-HBV-HCV-Lue

• Nel 2001-2002 abbiamo valutato 359 pazienti HIV+ italiani afferenti alla Divisione Clinicizzata di Malattie Infettive di Verona

Omosessuali = 88 ( 24,5%)

% B- C- B+C- B- C+ B+C+

HHV8- 19 24 2 2

HHV8+

51% 11 37 2 1

Tossicodipendenti = 191

( 53,5%)% B- C- B+C- B- C+ B+C+

HHV8-

8 3 23 45

HHV8+

21% 2 3 6 10

Eterosessuali = 80 (22%)

% B- C- B+C- B- C+ B+C+

HHV8- 36 24 5 9

HHV8+

26% 10 11 5 0

Coinfezione con Lue

• pz con Lue : 37 (10,3%)

• tra questi: 30 Omo, 5 Td, 2 Ete.

• tra i 30 Omo, 20 erano H+, 16 H+B+C- (il 18 % della coorte Omo)

Pazienti extracomunitari43 soggetti HIV+

• HHV8+ = 51%• HBV+ = 63%• Lue+ = 7%

Distribuzione dei Titoli

Anti litici20 - 80

Anti litici 160 - 320

Anti litici640 – 1280

1986-88 38% 31% 31%

1997-98 37% 52% 11%

HIV neg+ 11,5%

65% 35%

There are many controversies on the tests used to detect HHV-8 antibodies and on their significance. Lytic antigen assays appear to be more sensitive and yield not only higher, but more accurate seroprevalence rates [Hudnall 2003]. On the other hand, HHV-8-DNA in serum was detected only in individuals with antibodies to both latent and lytic antigens of HHV-8 [Enbom 2002].

The presence of anti-lytic antibodies indicates that active virus replication is necessary for diffusion of the virus or viral DNA to serum. An increased lysis of infected cells and thereby exposure of latent antigens is a possible explanation for the presence of anti-latent antibodies in DNA-positive subjects.

Risk factors for HHV8 infection among inmates in Italy: cOR and 95% CI (2)

0.0061.1-2.51.753/186 (28.5)HSV-2 pos

0.0011.6-3.12.2137/512 (26.7)AbHBc pos

0.070.9-1.81.388/370 (23.8)HCV pos

0.8-2.61.520/73 (27.4)HIV pos

Viral infections

0.6-1.30.9150/503 (20.8)> 1 year

162/283 (21.9)< 1 year

Duration of imprisonment

0.0221.1-5.82.3138/588 (23.4)At least one

18/70 (11.4)None

Previous imprisonment

P95%CI

cORHHV-8 pos/total (%)Variable

Risk factors for HHV8 infection among italian inmates, multivariate analysis: aOR and 95% CI

0.0151.1-3.11.8HSV-2-positive

<0.0011.7-4.42.7AbHBc-positive

0.270.8-1.91.3HCV-positive

0.620.4-3.61.3Previous imprisonments (yes vs

no)

0.0111.2-3.31.9Educational level (<8 vs >8yrs)

0.120.8-3.01.6Age >30 vs <30yrs

P95%CIcORVariable

Correlation between HHV8 Antibody titers, duration of imprisonment, HBV e HSV

0,00063,4%68,9%46,6%HBcAb

0,03101+70,490+8072,2+74,5Imprison. duration

0,01630,6%28,6%19,2%HSV-2

0,00640,2+9,939,3+10,436,9+10,6Age

>640

N° 35

40-320

N°123

Neg

N° 585

PHHV8 Ab

Many Thanks