Prevalence of Kaposi sarcoma-associated herpesvirus compared with selected sexually transmitted diseases in adolescents and young adults in rural Rakai District, Uganda.
BACKGROUND
Kaposi sarcoma-associated herpesvirus (KSHV) is transmitted by routes such as homosexual intercourse and is associated with HIV infection in industrialized countries. However, there is little information about its transmission in developing countries where Kaposi sarcoma is an endemic disease.


OBJECTIVE
To examine KSHV seroprevalence in young adults in a general, rural Ugandan population, and to compare this prevalence with rates of known sexually transmitted infections.


METHODS
The seroprevalence of KSHV was compared with the epidemiology of sexually transmitted diseases in 523 sexually active subjects aged 15 to 29 years who were randomly selected from a general population cohort in rural Rakai District, Uganda. Participants provided in-home interview data and specimens. Sera were tested for KSHV using immunofluorescence assay and immunoblot for lytically expressed recombinant KSHV ORF65.2. Sera were also tested for HIV type 1, herpes simplex virus type 2, and syphilis.


RESULTS
The prevalence of KSHV was significantly higher in participants 15 to 19 years compared with older persons 25 to 29 years (45.0% and 36.1%, respectively; adjusted odds ratio, 0.48; 95% CI, 0.28-0.82). In contrast, herpes simplex virus type 2 and HIV type 1 prevalence increased with age. Kaposi sarcoma-associated herpesvirus serostatus was not associated with HIV type 1, syphilis, herpes simplex virus type 2, or number of sexual partners. Homosexual and anal intercourse were reported by less than 1% of participants.


CONCLUSIONS
Kaposi sarcoma-associated herpesvirus does not appear to be a heterosexually transmitted infection in rural Uganda.
Center for Population and Family Health, Joseph L. Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
M J
MJ
Wawer
S M
SM
Eng
D
D
Serwadda
N K
NK
Sewankambo
N
N
Kiwanuka
C
C
Li
R H
RH
Gray
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood; D015331:Cohort Studies; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D015658:HIV Infections / Q000453:epidemiology; D006566:Herpesviridae Infections / Q000453:epidemiology* / Q000635:transmission; D019288:Herpesvirus 8, Human / Q000276:immunology / Q000302:isolation & purification*; D006716:Homosexuality; D006801:Humans; D015151:Immunoblotting; D008297:Male; D012423:Rural Health; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology; D016036:Seroepidemiologic Studies; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D013587:Syphilis / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology
D000914:Antibodies, Viral