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Human Herpesvirus 8
Human herpesvirus 8 (HHV-8) is an oncogenic virus identified in tissue specimens from patients with Kaposi sarcoma (KS). Because of this association, it is also known as Kaposi sarcoma–associated herpesvirus . HHV-8 is the etiologic agent of two additional lymphoproliferative disorders: primary effusion–based lymphoma (PEL) and multicentric Castleman disease (MCD) .
Etiology
HHV-8 is a γ 2 -human herpesvirus similar to Epstein-Barr virus. The virus contains a large DNA genome encoding 85-95 unique proteins. Infection is followed by both lytic and latent viral states with different degrees of viral replication associated with distinct disease manifestations.
Epidemiology
The prevalence of infection with HHV-8 varies both geographically and by population and roughly matches the epidemiology of KS. HHV-8 infection is endemic in Africa and parts of South America, with infection rates of up to 30–60% by adolescence. Seroprevalence >20% has also been found in regions bordering the Mediterranean. In contrast, infection rates <5% are noted in North America, central Europe, and Asia. However, within geographic regions, the prevalence of infection varies with risk behaviors, rates of 30–75% being found among men who have sex with men in North America and Europe. HHV-8 DNA can be detected in saliva, blood, semen, and tissues. Based upon large-scale epidemiologic studies and the high prevalence of viral shedding in oral secretions, saliva is believed to be the major mode of transmission. Other less-common routes of HHV-8 transmission include blood transfusion, bone marrow transplantation, and solid organ transplantation. Vertical transmission and transmission via breast milk may occur in regions where HHV-8 is highly endemic, but the risk appears low.
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