title: Risk factors for human herpesvirus 8 infection among adults in the United States and evidence for sexual transmission.
abstract: BACKGROUND
  Human herpesvirus 8 (HHV-8) causes Kaposi sarcoma. In the United States, transmission routes for HHV-8 are uncertain.
  
  
  METHODS
  The National Health and Nutrition Examination Survey III sampled individuals from the US general population (1988-1994). We used enzyme immunoassays (EIAs) to measure HHV-8 antibodies (K8.1 and open reading frame [ORF] 73 antigens) in 13,894 surveyed adults. HHV-8 seroprevalence was examined according to sexual history and viral coinfection markers.
  
  
  RESULTS
  Overall, seroprevalence was low when a highly specific cutoff was used (K8.1, 1.6%; ORF73, 1.5%) but was higher when a less-specific cutoff was used (K8.1, 7.1%; ORF73, 7.4%). When the more-specific approach was used, K8.1 seroprevalence was similar in men and women. Men who have sex with men (MSM) had a higher K8.1 seroprevalence (8.2%). Among other men, K8.1 seroprevalence was marginally associated with duration of heterosexual activity (P=.1) and was positively associated with the lifetime number of sex partners (P=.04) and with coinfections with hepatitis B virus (6.1% vs. 1.2% without coinfection; P<.001) and herpes simplex virus 2 (2.7% vs. 1.0%; P=.003). Among women, K8.1 seroprevalence was not significantly related to duration of sexual activity, the lifetime number of sex partners, or viral coinfections. The ORF73 EIA revealed similar but less clear-cut patterns.
  
  
  CONCLUSIONS
  Among men, HHV-8 transmission may occur through sexual activity, particularly sex with other men. No evidence was observed for heterosexual transmission to women.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Rockville, MD 20892, USA. engelse@exchange.nih.gov
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Jonnae O
authors.initials: JO
authors.lastname: Atkinson
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.forename: Geraldine M
authors.initials: GM
authors.lastname: McQuillan
authors.forename: Christine
authors.initials: C
authors.lastname: Gamache
authors.forename: Georgina
authors.initials: G
authors.lastname: Mbisa
authors.forename: Silvia
authors.initials: S
authors.lastname: Cohn
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D005260:Female; D019288:Herpesvirus 8, Human / Q000472:pathogenicity*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology*; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology* / Q000635:transmission; D014481:United States / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral