Determinants of Gammaherpesvirus Shedding in Saliva Among Ugandan Children and Their Mothers

Epstein Barr Virus (EBV) and Kaposi's sarcoma associated herpesvirus (KSHV) are transmitted via saliva but factors associated with salivary shedding are unknown. We measured the shedding of both viruses in the saliva of ~500 Ugandan mothers and their six-year old children, testing all participants for EBV and KSHV seropositive individuals for KSHV. EBV and KSHV were shed by 72% and 22% of the mothers, and by 85% and 40% of children, respectively; boys were more likely than girls to shed KSHV (48% versus 30%), but not EBV. Children shed more KSHV and EBV than mothers, however salivary of loads EBV and KSHV were similar. KSHV shedding increased with increasing anti-KSHV (K8.1) antibodies in mothers and with decreasing anti-malarial antibodies both in mothers and children. Among mothers, 40% of KSHV shedders also shed EBV, compared to 75% of KSHV non-shedders; for children, it was 65% versus 83%. In summary, in this population, individuals were more likely to shed EBV than KSHV in saliva; we have identified several factors, including child's sex, that influence KSHV shedding, and an inverse relationship between EBV and KSHV shedding, suggesting a direct or indirect interaction between the two viruses.