The association between the oral microbiome and oral Kaposi's sarcoma-associated herpesvirus (KSHV) shedding is modified by age and HIV status in a rural Ugandan cohort

Background Kaposi's sarcoma-associated herpesvirus (KSHV) spreads through saliva. KSHV shedding is intermittent, suggesting individual-level factors affect reactivation.Objective Identify associations between oral microbiome and KSHV shedding.Design Oral mouthwash samples from 67 KSHV-seropositive participants (ages 4–78) were tested for KSHV DNA by qPCR and microbiome composition via 16S rRNA V4 region sequencing (Illumina MiSeq, Earth Microbiome Project protocols). Samples were selected on age, self-reported HIV status, and KSHV shedding. Alpha and beta diversity and relative abundances at species, genus and phylum levels were compared by KSHV shedding status. Analyses of KSHV shedding and the oral microbiome were stratified by HIV status (n = 49 adults only) and by age (n = 37 without HIV only, children <18 vs adults ≥18).Results Neither alpha nor beta diversity differed by KSHV shedding status. Shedders had higher differential abundance of Prevotella multisaccharivorax, Bifidobacterium dentium, B. moukalabense and Bifidobacterium genus and lower Absconditabacteria G-1 bacterium HMT-875. Whether stratified by HIV and KSHV shedding or by age and KSHV shedding, alpha and beta diversity and several taxa at species, genus and phylum levels differed significantly.Conclusions Differences in oral microbiome were associated with KSHV shedding and possibly modified by age and HIV status. Future research should consider the multifactorial nature of the oral environment and KSHV reactivation.