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Does HHV-8 have a protective role on the development of HIV encephalopathy?

From the AIDS & STD Unit (Drs. Rezza, Dorrucci, Alliegro, and Pezzotti) and Laboratory of Virology (Drs. Monini and Ensoli), Istituto Superiore di Sanità, Infectious Disease Clinic (Drs. Andreoni and Nicastri) and Pediatric Neurology Unit (Dr. Arpino), University of Rome "Tor Vergata"; and Catholic University (Dr. De Luca), Rome, Italy.

Address correspondence and reprint requests to Dr. Giovanni Rezza, AIDS & STD Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; e-mail: g.rezza{at}iss.it

OBJECTIVE: To evaluate risk factors for HIV encephalopathy and whether Kaposi’s sarcoma (KS) and coinfection with human herpesvirus 8 (HHV-8) protect against this disease in a cohort of HIV seroconverters.

METHODS: Individuals with known dates of HIV seroconversion belonging to different HIV exposure categories (intravenous drug users, homosexual men, heterosexual contacts) were recruited by 17 clinical centers throughout Italy. Antibodies to HHV-8 lytic antigens were detected in a subgroup of participants using an immunofluorescence assay. Risk factors for HIV encephalopathy were evaluated using Cox proportional models. The association between KS or HHV-8 infection and HIV encephalopathy was evaluated using standard statistical techniques.

RESULTS: During the study period, 485 of the 1,520 participants developed acquired immunodeficiency syndrome, 38 of whom developed HIV encephalopathy. HHV-8 serologic status was determined for 390 participants. Male gender, injecting drug use, and low CD4 T-cell count were associated with HIV encephalopathy; none of the 63 participants with KS developed this disease. The risk of HIV encephalopathy did not differ significantly by HHV-8 serologic status.

CONCLUSIONS: HIV encephalopathy was found to be associated with male gender and intravenous drug use. The risk increased at lower CD4 T-cell counts. Although HIV encephalopathy occurred less frequently in patients with KS, no association with HHV-8 infection was found.

Key words: HHV-8—HIV encephalopathy.

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				S. Polk, A. Munoz, N. C. Sacktor, F. J. Jenkins, B. Cohen, E. N. Miller, and L. P. Jacobson A case-control study of HIV-1-related dementia and co-infection with HHV-8 Neurology, September 24, 2002; 59(6): 950 - 953. [Abstract] [Full Text] [PDF]

				B. J. Brew, G. Rezza, C. Arpino, M. Dorrucci, and D Stat Does HHV-8 have a neuroprotective role on the development of HIV encephalopathy? Neurology, August 8, 2000; 55(3): 459 - 460. [Full Text] [PDF]