Kaposi Sarcoma–Associated Herpesvirus (KSHV) Seroprevalence in Population‐Based Samples of African Children: Evidence for At Least 2 Patterns of KSHV Transmission

Abstract

Background Kaposi sarcoma–associated herpesvirus (KSHV) infection is endemic among adult populations in Africa. A prevailing view is that childhood transmission is primarily responsible for the high seroprevalence of KSHV among adults that is observed throughout the continent. However, few studies have directly examined children, particularly in locations where KS is not commonly endemic. Methods Participants were children aged 1.5−8.9 years, including 427 children from a population-based sample in South Africa, 422 from a population-based sample in Uganda, and 567 from a clinic-based sample in Uganda. All serum specimens were tested by the same laboratory for KSHV antibodies with use of 2 enzyme immunoassays (against K8.1 and ORF65) and 1 immunofluorescence assay. Results KSHV seroprevalence was 7.5%−9.0% among South African children and was not associated with age. In contrast, in the Ugandan population-based sample, KSHV seroprevalence increased from 10% among 2-year-old children to 30.6% among 8-year-old children (Ptrend < .001). In the Ugandan clinic-based sample, seroprevalence increased from 9.3% among 2-year-old children to 36.4% among 8-year-old children (Ptrend < .001). Conclusion Two distinct relationships between age and KSHV infection among children imply that KSHV transmission among children is not uniform throughout Africa and is therefore not always responsible for the high seroprevalence observed in adults. There are at least 2 patterns of KSHV transmission in Africa.

Seroprevalence of Kaposi's sarcoma‐associated herpesvirus among men who have sex with men in Japan

“…Although the transmission route of KSHV remains unclear, the higher seroprevalence of KSHV between men who have sex with men than that among the general population suggests that transmission likely occurs through homosexual behaviors in non-endemic areas, such as in the USA, Europe, and Asia [Goudsmit et al, 2000;Diamond et al, 2001]. In contrast, in KSHV endemic areas, such as Africa, a high seroprevalence of KSHV has been found even among children [Bourboulia et al, 1998;Butler et al, 2009]. Since high copy numbers of KSHV have been detected in the saliva of those infected with KSHV, vertical mother-tochild transmission may occur through saliva [Pauk et al, 2000;Mbulaiteye et al, 2006].…”

Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma

“…Other risk factors for KSHV transmission in childhood include type of water supply and socioeconomic status of mothers[14; 59]. There is some evidence that the patterns of transmission of KSHV may differ in different parts of sub-Saharan Africa and this is an area that warrants further study[63]…”

Increased prevalence of Kaposi΄s sarcoma-associated herpesvirus in the Kaposi΄s sarcoma-endemic area of Western Kenya in 1981–2000

“…High prevalence of KSHV was observed in Uganda (14-86%), Congo (25-82%), Nigeria (6-56%), South Africa (16-75%), Ivory Coast (43-100%), Vietnam (11.3-15.5%), Colombia (13%), and Costa Rica (11.1%) (Sitas and Newton, 2001;Dedicoat and Newton, 2003;Sanjose, et al, 2009;Butler, et al, 2009). Therefore, it is conceivable that endemic KS may be caused by KSHV infection.…”