title: Demographic and immune correlates of human herpesvirus 8 seropositivity in Malawi, Africa.
abstract: BACKGROUND
  In the USA, human herpesvirus 8 (HHV-8) is associated with Kaposi's sarcoma (KS) and HIV infection. We examined HHV-8 seroprevalence in a Malawian cohort, and assessed its relationship with HIV, KS, demographic characteristics, and immune findings.
  
  
  METHODS
  In 1997 and 1998, blood samples were obtained from 272 hospitalized Malawian patients, for whom demographic information was obtained, and 24 healthy volunteers without demographic data. We used enzyme immunoassays to assess seroprevalence and antibody titers to peptide antigens derived from HHV-8 K8.1 and ORF65-encoded proteins. Intracellular cytokines and cell surface antigens were assessed with four-color flow cytometry. Data were analyzed using non-parametric univariate and regression analytic techniques.
  
  
  RESULTS
  The rates of HHV-8 seroprevalence to either or both HHV-8 peptides were 67% for the patients and 54% for the healthy volunteers. Seroprevalence increased with patients' age (P<0.001) but was not associated with HIV status, percentage of lymphocytes expressing CD4, or KS (n=10). Seropositive females had lower antibody titers to both peptides than did males (medians: 455 versus 1361 for K8.1, P<0.001; and 268 versus 405 for ORF65, P=0.044). For the healthy volunteers, the percentage of CD8+ cells producing IFN-gamma after stimulation was significantly lower in ORF65-specific antibody-positive persons (medians: 24% versus 57%, P=0.008).
  
  
  CONCLUSIONS
  In Malawi, HHV-8 is endemic and is not associated with HIV infection or HIV severity. Seroprevalence rates increase in childhood, and, most steeply in adolescence. Titers are higher in seropositive males than in sero-positive females. The immune effects of HHV-8 in healthy adults are consistent with chronic inhibition of type 1 cytotoxic T-cell responsiveness, independent of HIV status.
authors.affiliation: HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research, Centers for Disease Control and Prevention, US Department of Health and Human Services, US Public Healtrh Service, Atlanta, GA 30333, USA.
authors.forename: Stacia M
authors.initials: SM
authors.lastname: DeSantis
authors.forename: Chou-Pong
authors.initials: CP
authors.lastname: Pau
authors.forename: Lennox K
authors.initials: LK
authors.lastname: Archibald
authors.forename: Okey C
authors.initials: OC
authors.lastname: Nwanyanwu
authors.forename: Peter N
authors.initials: PN
authors.lastname: Kazembe
authors.forename: Hamish
authors.initials: H
authors.lastname: Dobbie
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
authors.forename: Janine
authors.initials: J
authors.lastname: Jason
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000821:virology; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D003710:Demography; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000276:immunology*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral; D016207:Cytokines