Blood-borne and sexual transmission of human herpesvirus 8 in women with or at risk for human immunodeficiency virus infection.
BACKGROUND
Human herpesvirus 8 (HHV-8), the causal agent of Kaposi's sarcoma, is transmitted sexually among homosexual men, but little is known of its transmission among women. Although HHV-8 has been detected in blood, there has been no clear evidence of blood-borne transmission.


METHODS
We identified risk factors for HHV-8 infection in 1295 women in Baltimore, Detroit, New York, and Providence, Rhode Island, who reported high-risk sexual behavior or drug use. HHV-8 serologic studies were performed with two enzyme-linked immunosorbent assays.


RESULTS
In univariate analyses, HHV-8 was associated with black race, Hispanic ethnic background, a lower level of education, and infection with syphilis, the human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). The risk of seropositivity for HHV-8 increased with the frequency of injection-drug use (P<0.001); HHV-8 seroprevalence among the women who used drugs daily was three times that among women who never injected drugs. Among the women with a low risk of sexual transmission, HHV-8 seroprevalence was 0 percent in those who had never injected drugs and 36 percent in those who had injected drugs (P<0.001). However, injection-drug use was linked less strongly to HHV-8 infection than to infection with HBV or HCV. In a multivariate analysis, independent predictors of HHV-8 seropositivity included HIV infection (odds ratio, 1.6; 95 percent confidence interval, 1.1 to 2.2), syphilis infection (odds ratio, 1.8; 95 percent confidence interval, 1.1 to 2.8), and daily injection-drug use (odds ratio, 3.2; 95 percent confidence interval, 1.4 to 7.6).


CONCLUSIONS
Both injection-drug use and correlates of sexual activity were risk factors for HHV-8 infection in the women studied. The independent association of HHV-8 infection with injection-drug use suggests that HHV-8 is transmitted through needle sharing, albeit less efficiently than HBV, HCV, or HIV.
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
M J
MJ
Cannon
S C
SC
Dollard
D K
DK
Smith
R S
RS
Klein
P
P
Schuman
J D
JD
Rich
D
D
Vlahov
P E
PE
Pellett
D000328:Adult; D000704:Analysis of Variance; D017848:Blood-Borne Pathogens / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006525:Hepatitis, Viral, Human / Q000150:complications; D006566:Herpesviridae Infections / Q000453:epidemiology / Q000209:etiology / Q000635:transmission*; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D020010:Heterosexuality; D006801:Humans; D016015:Logistic Models; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013587:Syphilis / Q000150:complications