Taylor MM, The Journal of Infectious Diseases 2004; 190:484–8.

Presentazione sul tema: "Taylor MM, The Journal of Infectious Diseases 2004; 190:484–8."— Transcript della presentazione:

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3 Taylor MM, The Journal of Infectious Diseases 2004; 190:484–8

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9 Manifestazioni cliniche in 81 bambini correlate con i risultati del test serologico e della PCR per HHV8 Dati clinici Resultati di IFA e PCR per HHV8 (%) Ab - / PCR + (n=6) Ab + / PCR + (n=14) Ab + / PCR - (n=17) Ab - / PCR - (n=44) esantema5 (83.3)*2 (14.3)3 (17.6)5 (11.3) tosse2 (33.3)5 (35.7)7 (44.1)17 (38.6) angina5 (83.3)13 (92.8)16 (94.1)40 (90.9) linfoadenopatia07 (50)13 (76.5)32 (72.7) diarrea1 (16.6)2 (14.3)4 (23.6)13 (29.5) convulsioni1 (16.6)1 (7.2)1 (5.9)6 (13.6) ulcere orali dolorose 02 (14.3)4 (23.6)8 (18.2) altro002 (11.8)2 (4.5) *p= 0.016 3/3 casi sieroconversione a 6 mesi Andreoni JAMA. 2002 Mar 13;287(10):1295-300

10 Sarcoma di Kaposi

11 Sarcoma di Kaposi orale e polmonare

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15 Coinfezione HIV-HHV8-HBV-HCV-Lue Nel 2001-2002 abbiamo valutato 359 pazienti HIV+ italiani afferenti alla Divisione Clinicizzata di Malattie Infettive di Verona

16 Omosessuali = 88 ( 24,5%)

17 Tossicodipendenti = 191 ( 53,5%)

18 Eterosessuali = 80 (22%)

19 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)

20 Pazienti extracomunitari 43 soggetti HIV+ HHV8+ = 51% HBV+ = 63% Lue+ = 7%

21 Distribuzione dei Titoli Anti litici 20 - 80 Anti litici 160 - 320 Anti litici 640 – 1280 1986-8838%31% 1997-9837%52%11% HIV neg + 11,5% 65%35%

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24 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.

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28 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 P 95%CI cOR HHV-8 pos/total (%) Variable

29 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 ( 8yrs) 0.120.8-3.01.6Age >30 vs <30yrs P95%CIcORVariable

30 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

31 Many Thanks