Prevalence and determinants of anti-lytic and anti-latent antibodies to human herpesvirus-8 among Italian individuals at risk of sexually and parenterally transmitted infections

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Abstract
Three hundred seventy‐nine individuals [137 non‐injecting drug using (non‐IDU) heterosexuals, 130 homosexual men and 112 IDU] attending the human immunodeficiency virus (HIV) testing program of a sexually transmitted disease (STD) clinic in Rome were studied to estimate the prevalence and to identify the modalities of transmission of human herpesvirus‐8 (HHV‐8) infection. Serological analysis was performed by using an immunofluorescence assay able to detect anti‐latent and anti‐lytic HHV‐8 antibodies. Twelve acquired immunodeficiency syndrome (AIDS)‐Kaposi's sarcoma (KS) patients and 94 blood donors were tested as reference population groups. Anti‐lytic antibodies were detected in 185 (48.8%) individuals; 52 of them (13.7%) also had anti‐latent antibodies. Both anti‐lytic and anti‐latent antibody prevalence were higher among homosexual men (66.9% and 27.7%, respectively) than among IDU (49.1% and 8.0%, respectively) and non‐IDU heterosexuals (31.4% and 5.1%, respectively), and tended to increase with age. Anti‐lytic HHV‐8 antibodies were associated with syphilis [odds ratio (OR) = 3.81] but not with hepatitis C virus (HCV) seropositivity. HIV‐infected homosexual men were more likely to have HHV‐8 antibodies than those who were HIV‐negative. When using anti‐latent antibodies the direction of the OR remained the same, although the associations did not often reach statistical significance. Among AIDS‐KS patients, 83.3% had anti‐lytic and 66.6% had anti‐latent antibodies. Among blood donors, 28% had anti‐lytic antibodies and 2 of them (2.1%) also had anti‐latent antibodies. Our data indicate that HHV‐8 seroprevalence increases with age and is higher among homosexual men, particularly those infected with HIV. This is consistent with sexual transmission of HHV‐8 infection. In addition, the presence of HHV‐8 antibodies in HIV‐negative non‐IDU heterosexual contacts and in healthy blood donors is consistent with the high incidence of classic KS in Italy. Int. J. Cancer. 77:361–365, 1998.