Salivary Shedding, Viremia, and Seroprevalence of Kaposi´s Sarcoma-Associated Herpes Virus Among a Cohort of Men Who Have Sex With Men and Transgender Women in Argentina.

FINK V; PEREZ C; LACUNZA E; GUN A; SANDOVAL M; IANNANTUONO V; TOUS M; ABBA MC; COSO O; CAHN P; MESRI E

Conferencia; 18th International Conference on Malignancies in HIV/AIDS; 2022

Kaposi´s sarcoma is still one of the most frequent AIDS defining cancers among people with HIV in Latin America. Data on Kaposi’s sarcoma-associated herpesvirus (KSHV) remain scarce. Men who have sex with men (MSM) and transgender women (TGW) are the populations most affected by HIV in Argentina. As part of a project studying virally induced AIDS malignancies, we aim to study KSHV infection and associated factors within a cohort of people with or at high risk of HIV in Argentina. Updated baseline data are presented. MSM and TGW were recruited at Fundación Huésped between April 2018 and August 2021. All patients signed informed consent prior to study procedures. Medical information was obtained and samples derived from blood and saliva were collected and stored at -70°C. DNA from whole blood and saliva samples was extracted using QIAamp DNA Mini Kit (QIAGEN); IFA for lytic antibodies on TPA-induced BCBL-1 cells and PCR reactions were performed. KSHV serology was done by indirect immunofluorescence assay.Patients recruited: 144 MSM (111 with HIV) and 81 TGW (39 with HIV). The median age was 33.9 years (interquartile range [IQR] 29.1–41-5). Participants were born in Argentina (n=179), Venezuela (n=14), Peru (n=11), Paraguay (n=9), Colombia (n=7), Ecuador (n=3), and Brazil and Bolivia (n=1 each). Almost all TGW (91%) and 13% MSM were current or past sexual workers. Deep kissing was reported by 96% of participants. Two percent of subjects used intravenous drugs in the past, 61% used non-intravenous drugs, 21% used stimulants, and 55% ever used tobacco. Among TGW, 38% were receiving gender-affirming hormones. Among participants with HIV (PWH), median CD4 cell count was 622 cells/ul (IQR: 408–807 cells/ul). Six patients had previous or concomitant Kaposi´s sarcoma, and four had active clinical disease. Serological analysis showed that 65% of the population was infected with KSHV (68% of the TGW and 36% of the MSM; 72% PWH). KSHV was detected in 29% of the saliva samples (33% TGW and 26% MSM; 77% PWH) and in 15% of whole blood samples (13% TGW and 15% MSM; 81% PWH). Eighteen patients had KSHV detected in both blood and saliva, all with positive serology. KSHV in saliva and whole blood, as well as positive KSHV serology, were associated with HIV infection (p= 0.043, 0.046 and 0.014, respectively). In this expanded cohort, the prevalence of KSHV infection remains high among the studied population. Seroprevalence was 65%; in particular, among TGW (68%). Salivary shedding was higher than viremia. People with HIV were more likely to have KSHV infection detected by any of the used techniques. This study is expected to provide information that might aid in the design of public health policies and KS prevention strategies. This work is funded by National Institutes of Health 2P30AI073961/U54 CA221208. Partial results were presented at IAS 2019 and ICMH 2019.