Risk factors for human herpesvirus 8 seropositivity and seroconversion in a cohort of homosexual men

Sexual and nonsexual modes of transmission of human herpesvirus 8 (HHV8) ha ve been suggested, but specific routes remain unclear. Therefore, the objec tive of this study was to assess risk factors for HHV8 seropositivity and d etermine specific sexual practices associated with HHV8 seroconversion. Ser a from 1,458 homosexual men (Amsterdam Cohort Study, 1984-1996) were tested for antibodies to HHV8 with a modified version of an enzyme immunoassay, u sing recombinant HHV8 lytic phase capsid (ORF65) and latent phase nuclear ( ORF73) proteins. HHV8 seroprevalence at study entry was 20.9% (305/1,458); was highest among those with positive human immunodeficiency virus (HIV) st atus, no steady partner, and southern European or Latin American nationalit y; and increased with older age and higher number of sexual partners. Durin g follow-up, 215 men seroconverted for HHV8 (incidence: 3.6/100 person-year s). Both prevalence and incidence rates remained more or less stable during the study period. Orogenital insertive sex (odds ratio (OR) = 5.95; 95% co nfidence interval (CI): 2.88, 12.29) or orogenital receptive sex (OR = 4.29 ; 95% CI: 2.11, 8.71) with more than five partners in the past 6 months, ol der age (OR = 2.89; 95% CI: 1.13, 7.34, when older than 45 years), and prec eding HIV infection (OR = 2.47; 95% CI: 1.53, 3.99) were independent predic tors for HHV8 seroconversion. The authors found strong evidence for orogeni tal transmission of HHV8 among homosexual men.