Association Between Herpes And Diabetes In Sub-Saharan Africa

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Main Category: Diabetes
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 19 Jun 2008 - 0:00 PDT

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A study published in the June 18 issue of JAMA reports a link between an atypical form of type 2 diabetes and antibodies for a virus called human herpesvirus 8 (HHV-8). Eugène Sobngwi, M.D., Ph.D. (Hôpital Saint-Louis, Paris) and colleagues found the association in people from sub-Saharan Africa.

In African populations, one of the most common forms of diabetes since 1987 has been an atypical type - ketosis-prone type 2 diabetes mellitus (DM-2). Ketone bodies are byproducts of the fat metabolism process, and ketosis occurs when ketone bodies aggregate in the body's tissues and fluids. Since this atypical diabetes type appears suddenly, the researchers believe that there are factors that trigger its onset.

This recent study is based on the hypothesis that, "Ketosis-prone DM-2 may be associated with a viral infection, which may also be the acute and reversible precipitating phenomenon. Indeed, viruses may induce both insulin resistance and insulin secretory defect," according to the authors. "Because of the acute onset of ketosis-prone DM-2 and the high prevalence of ketosis-prone DM-2 in populations of African origin, we searched for a virus that is commonly found in this population." In sub-Saharan Africa, HHV-8 is endemic - 30 to 60 percent of adults have markers for the infection.

In order to test for an association between HHV-8 infection and ketosis-prone DM-2, the researchers conducted a study at Saint-Louis University Hospital in Paris from January 2004 to July 2005. The participants, all black and of African origin, consisted of 187 diabetic patients (81 with ketosis-prine DM-2 and 106 with non-ketotic DM-2). This group was compared to 90 non-diabetic control participants, appropriately matched for age and sex. Researchers assessed the presence of HHV-8 in genomic DNA in 22 participants when it was clinically determined that diabetes has presented.

The researchers found HHV-8 antibodies in:

• 71 patients (87.7%) with ketosis-prone DM-2
• 16 patients (15.1%) with non-ketotic DM-2
• 36 of the control participants (40.0%)

In addition, HHV-8 in genomic DNA was found in 6 of 13 ketosis-prone DM-2 patients tested at acute onset and in none of the 9 patients with non-ketotic DM-2 tested at acute onset.

The authors clarify that, "Our preliminary study shows a strong link between ketosis-prone DM-2 phenotype and markers of HHV-8 infection. Patients with ketosis-prone DM-2 have a very high prevalence of HHV-8 infection, whereas patients with non-ketotic DM-2 have a much lower prevalence of HHV-8 infection when compared with the background population. Thus, the prevalence of HHV-8 seropositivity is almost 6-fold higher in patients with ketosis-prone DM-2 compared with non-ketotic DM-2 patients."

"These results need to be replicated in other populations and longitudinal studies are required to understand the clinical significance of these findings," conclude the researchers.

Ketosis-Prone Type 2 Diabetes Mellitus and Human Herpesvirus 8 Infection in Sub-Saharan Africans
Eugène Sobngwi, MD, PhD; Siméon Pierre Choukem, MD; elix Agbalika, MD, MSc Bertrand Blondeau, PhD; Lila-Sabrina Fetita, MD; Céleste Lebbe, MD, PhD; Doudou Thiam, MD; Pierre Cattan, MD, PhD; Jérôme Larghero, MD, PhD; Fabienne Foufelle, PhD; Pascal Ferre, PhD; Patrick Vexiau, MD; Fabien Calvo, MD, PhD; Jean-François Gautier, MD, Ph
JAMA (2008). 299[23]: pp. 2770 - 2776.
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Written by: Peter M Crosta
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