Association between human herpes 8 infection and ketotic type 2 diabetes.

An atypical form of type 2 diabetes that presents with ketosis in sub-Saharan blacks has been found to be associated with human herpesvirus 8 (HHV-8), according to a recent paper published in the Journal of the American Medical Association.

Eugene Sobngwi and colleagues carried out a cross-sectional study in which antibodies were searched against latent and lytic HHV-8 antigens using immunofluorescence. The presence of HHV-8 in genomic DNA was investigated in 22 of the participants at clinical onset of diabetes. They also tested whether HHV-8 was able to infect human pancreatic [beta] cells in culture in vitro. The study was conducted at Saint Louis University Hospital, Paris, France, from January 2004 to July 2005. All participants were black and of African origin: 187 were consecutive diabetic patients of whom 81 had ketosis-prone diabetes mellitus type 2 (DM-2) and 106 had non-ketotic DM-2, and 90 individuals were non-diabetic control participants who were matched for age and sex.

HHV-8 antibodies were found in 71 patients (87.7%) with ketosis-prone DM-2 versus 16 patients (15.1%) with nonketotic DM-2 (odds ratio (OR) 39.9; 95% confidence interval (CI) 17.1-93.4; p<0.001) and 36 of the control participants (40.0%) (OR 10.7; 95% CI 4.9-23.4; p<0.001). HHV-8 in genomic DNA was present in 6 of 13 patients with ketosisprone DM-2 tested at acute onset and in 0 of 9 patients with non-ketotic DM-2. HHV-8 proteins were present in human islet cells that were cultured for 4 days in the presence of HHV-8.

They concluded that the presence of HHV-8 antibodies was associated with ketosisprone DM-2 in patients of sub-Saharan African origin. Longitudinal studies are required to understand the clinical significance of these findings.

Sobngwi E, et al. JAMA 2008; 299: 2770-2776.