Prevalence, Risk Factors, and Shedding of Human Herpes Virus-8 Among Men Having Sex With Men Enrolled in a Pre-exposure Prophylaxis Study

Abstract

Abstract Background Seroprevalence and risk factors for human herpesvirus-8 (HHV-8) infection among HIV-negative men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) have not been well characterized. Our objectives were to assess the prevalence and incidence of HHV-8 infection in MSM enrolled on PrEP, and study viral shedding in seropositive participants. Methods The ANRS IPERGAY study enrolled 429 participants in France and Canada to evaluate oral PrEP for HIV-1 prevention. Stored sera samples at day 0 (D0) and last visit were tested for the detection of HHV-8 antibodies using an indirect immunofluorescence assay. Baseline characteristics were analyzed to identify risk factors associated with HHV-8 seropositivity. Among seropositive participants, HHV-8 DNA was quantified on available oral and anal swabs, and ORF-K1 typing performed on HHV-8 positive samples. Results One hundred participants were seropositive at D0 (prevalence of 24%; 95% CI: 20.0–28.4%) and 18/329 seroconverted during the study (incidence rate of 2.66 per 100 person-years; 95% CI: 1.57–4.20). Risk factors independently associated with baseline HHV-8 seropositivity included older age, high number of sexual partners, chemsex use, and herpes simplex virus 2 (HSV-2) seropositivity. Among HHV-8–seropositive participants with available swab(s) for virological analysis, 37/115 (32%) displayed HHV-8 oral shedding and 5/113 (4.4%) anal shedding at least once. Four patients had a positive viral load before seroconversion. Conclusions Prevalence and incidence of HHV-8 infection were high in HIV-negative PrEP users. Among seropositive participants, HHV-8 DNA is mainly detected in saliva, which may play a major role in viral transmission in this population. Clinical Trials Registration. ClinicalTrials.gov, NCT01473472.