Human herpesvirus 8 seroprevalence and evaluation of nonsexual transmission routes by detection of DNA in clinical specimens from human immunodeficiency virus seronegative patients from central and southern Italy, with and without Kaposi's sarcoma

In order to investigate the seroprevalence of human herpesvirus 8 (HHV-8) i nfection in central and southern Italy, sera from human immunodeficiency vi rus (HIV)-seronegative subjects, with and without Kaposi's sarcoma (KS), we re analyzed by immunofluorescence assay, using BC-3, a cell line latently i nfected with HHV-8, High titers of antibody against HHV-8 lytic and latent antigens were detected in all 50 KS patients studied, while in 50 HIV-seron egative subjects without KS, 32 (64%) were found positive for HHV-8 antibod ies. Titers in the sera of these patients mere lower than those for KS pati ents. This data suggests that HHV-8 infection is not restricted to KS patie nts and that the prevalence of HHV-8 infection in the general population ma y be correlated with differing rates of prevalence of KS in different parts of the world. In view of these findings, possible nonsexual transmission r outes were evaluated. Nested PCR was used to test for the presence of HHV-8 DNA in saliva, urine, and tonsillar swabs from KS and non-KS patients. In KS patients, 14 out of 32 tonsillar swabs (43.7%), 11 out of 24 saliva samp les (45.8%), and just 2 out of 24 urine samples (8.3%) tested positive for HHV-8 DNA. In the control group, on the contrary, none of the 20 saliva and 20 urine specimens was positive for HHV-8 DNA; only 1 out of 22 tonsillar swabs gave a positive result. This data supports the hypothesis that HHV-8 infects the general population in a latent form. The reactivation of viral infection may result in salivary shedding of HHV-8, contributing to viral s pread by nonsexual transmission routes.