American Journal of Epidemiology Advance Access published online on May 30, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn125
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original Contribution |
Early Childhood Infection by Human Herpesvirus 8 in Zambia and the Role of Human Immunodeficiency Virus Type 1 Coinfection in a Highly Endemic Area
1 Nebraska Center for Virology and School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE
2 US Centers for Disease Control and Prevention Global AIDS Program, Lusaka, Zambia
3 Department of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
4 National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
5 Department of Pediatrics, University of Miami School of Medicine, Miami, FL
Correspondence to Dr. Charles Wood, Room 102C, Morrison Center, University of Nebraska-Lincoln, 4240 Fair Street, Lincoln, NE 68583 (e-mail: cwood1{at}unl.edu).
Received for publication November 13, 2007. Accepted for publication April 14, 2008.
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.
herpesvirus 8, human; HIV-1; infection; sarcoma, Kaposi; Zambia
Abbreviations: HHV-8, human herpesvirus 8; HIV-1, human immunodeficiency virus type 1; mIFA, monoclonal antibody-enhanced immunofluorescence assay; Sf9, Spodoptera frugiperda clone 9