Early Childhood Infection by Human Herpesvirus 8 in Zambia and the Role of Human Immunodeficiency Virus Type 1 Coinfection in a Highly Endemic Area

Authors

Veenu Minhas, University of Nebraska-LincolnFollow
Kay L. Crabtree, University of Nebraska-LincolnFollow
Ann Chao, United States Centers for Disease Control and PreventionFollow
Tendai J. M'sola, University Teaching Hospital, Lusaka, Zambia
Chipepo Kankasa, University Teaching Hospital, Lusaka, Zambia
Marc Bulterys, United States Centers for Disease Control and Prevention
Charles D. Mitchell, University of MiamiFollow
Charles Wood, University of Nebraska-LincolnFollow

Document Type

Article

Date of this Version

2008

Comments

Published in the American Journal of Epidemiology (2008), v. 168, no. 3: 311-320.

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 ¼ 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.