Early childhood infection by human herpesvirus 8 in Zambia and the role of human immunodeficiency virus type 1 coinfection in a highly endemic area

Veenu Minhas, Kay L. Crabtree, Ann Chao, Tendai J. M'soka, Chipepo Kankasa, Marc Bulterys, Charles D. Mitchell, Charles Wood

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Abstract

Kaposi's sarcoma occurs at high incidence among Zambian adults and children, but there is a paucity of data on human herpesvirus 8 (HHV-8) incidence and routes of infection, especially in children. Between 1998 and 2004, the authors conducted a prospective study of viral transmission in a cohort of 684 children in Lusaka, Zambia, to estimate the annual incidence of HHV-8 from birth through 48 months of age. Maternal and pediatric human immunodeficiency virus type 1 (HIV-1) infection status was also determined. The results, based on 1,532 child-years of follow-up, showed that HHV-8 seroconversion occurs early in life. The incidence rate of HHV-8 seroconversion was 13.8 infections per 100 child-years by 48 months of age. HIV-1-infected children were at substantially higher risk for HHV-8 seroconversion (adjusted hazard ratio = 4.60, 95% confidence interval: 2.93, 7.22). Maternal HIV-1 and HHV-8 infection status were not independently associated with risk of HHV-8 seroconversion in the child. HHV-8 antibody titers in children followed at all consecutive time points revealed seroreversion of HHV-8 antibodies, with undetectable titers in some children at one or more time points after seroconversion. These results demonstrate that cross-sectional serologic screening probably underestimates true HHV-8 seroprevalence in young Zambian children because of fluctuations in detectable antibody titers.

Original languageEnglish (US)
Pages (from-to)311-320
Number of pages10
JournalAmerican Journal of Epidemiology
Volume168
Issue number3
DOIs
StatePublished - Aug 1 2008

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Keywords

  • HIV-1
  • Herpesvirus 8, human
  • Infection
  • Sarcoma, Kaposi
  • Zambia

ASJC Scopus subject areas

  • Epidemiology

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