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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