Antibody reactivity to latent and lytic antigens to human herpesvirus-8 in longitudinally followed homosexual men

Tests for human herpesvirus-8 (HHV-8) often disagree on which individuals are infected. To evaluate HHV-8 antibody changes over many years, 245 homosexual men enrolled in a prospective study between 1982 and 1999 were studied. Samples collected annually were evaluated by immunofluorescence to HHV-8 latent nuclear antigen and by an ELISA for antibody against the HHV-8 lytic antigen K8.1. When positive, samples from most subjects were persistently reactive in both assays. Titers to both lytic and latent antibodies increased for many years, usually in parallel, and were higher in human immunodeficiency virus-infected men. The increasing titers and expanding epitope recognition suggest ongoing, low-grade replication of HHV-8. Use of multiple assays is important in determining prevalence in asymptomatic populations. Because persons with more advanced infections have higher antibody titers, they are easier to detect, which may skew our understanding of the epidemiology of HHV-8.