title: Risk factors for Kaposi's sarcoma-associated herpesvirus infection among HIV-1-infected pregnant women in the USA.
abstract: OBJECTIVE
  We sought to identify risk factors for infection with the Kaposi's Sarcoma-associated herpesvirus (KSHV) among pregnant women and to examine a reported association of KSHV with injecting drug use (IDU) and hepatitis C virus (HCV) infection.
  
  
  METHODS
  Cross-sectional evaluation of questionnaire data and KSHV and HCV seroprevalence in the Women and Infants Transmission Study.
  
  
  METHODS
  In sera collected from HIV-1-infected pregnant women (n = 887) and, at age 12 months, their offspring (n = 900) at six sites in the USA and Puerto Rico, KSHV and HCV antibodies were detected with sensitive and specific enzyme immunoassays. Risk of KSHV was estimated by the unadjusted and adjusted odds ratio (OR(adj)) and 95% confidence interval (CI). The geographic referent sites were Chicago and Boston.
  
  
  RESULTS
  Forty-seven (5.3%) of the women and three (0.3%) of the infants were KSHV seropositive. In univariate and multivariate analyses, KSHV in the women was associated with enrollment in Puerto Rico, Houston or Brooklyn (OR(adj), 4.3; 95% CI, 1.8-10.4) or Manhattan (OR(adj), 9.8; 95% CI, 3.7-25.6); non-completion of high school (OR(adj), 1.8; 95% CI, 0.9-3.4); the number of sexually transmitted diseases (OR(adj), 1.4; 95% CI, 1.0-1.9 per disease); and especially with IDU and HCV infection (OR(adj), 3.5; 95% CI, 1.5-7.9).
  
  
  CONCLUSIONS
  Transmission of KSHV by blood inoculation may be highly inefficient, but our data support the hypothesis that it does occur. Large formal studies to evaluate whether KSHV transmission occurs via transfusion are needed to inform decisions regarding screening volunteer blood donors to protect the blood supply.
authors.affiliation: Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Rockville, MD 20892, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: Manhattan
authors.initials: M
authors.lastname: Charurat
authors.forename: William A
authors.initials: WA
authors.lastname: Blattner
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Hershow
authors.forename: Jane
authors.initials: J
authors.lastname: Pitt
authors.forename: Clemente
authors.initials: C
authors.lastname: Diaz
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Mofenson
authors.forename: Karen
authors.initials: K
authors.lastname: Green
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: Mary E
authors.initials: ME
authors.lastname: Paul
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000635:transmission*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D012044:Regression Analysis; D012307:Risk Factors; D021841:Safe Sex; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000209:etiology*; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D014481:United States / Q000453:epidemiology