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

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.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. The prevalence and incidence of HHV-8 infection are elevated in high-risk HIV-negative pre-exposure prophylaxis users. Among seropositive participants, HHV-8 DNA is mainly detected in saliva, which may play a major role in viral transmission in this population through oral sex.