title: Geographic heterogeneity of prevalence of the human herpesvirus 8 in sub-Saharan Africa: clues about etiology.
abstract: OBJECTIVE
  Human herpesvirus 8 (HHV-8, or Kaposi sarcoma [KS]-associated herpesvirus, KSHV) is a necessary but insufficient cause of KS, as KS develops in few HHV-8-infected persons. In sub-Saharan Africa, marked differences in the geographic distribution of HHV-8 and KS suggest that environmental cofactors influence HHV-8 transmission, control, and progression to KS. However, a direct comparison of HHV-8 prevalence estimates is complicated because studies used different serologic assays and analytic methods. We assessed HHV-8 seropositivity in several African countries with heterogeneous environments and varying KS incidence using a unified approach.
  
  
  METHODS
  HHV-8 antibodies were measured among 3196 adults (aged 20+ years) and 2404 children (aged <20 years) from five studies in four sub-Saharan countries in Africa. Serum samples were tested by the same laboratory using K8.1 and orf73 enzyme immunoassays.
  
  
  RESULTS
  Children's HHV-8-seropositivity ranged from 18.1% in Kampala, Uganda, to 33.8% in North Mara, Tanzania, increasing steeply with age in all populations. Among adults, HHV-8-seropositivity ranged from 23.5% in Nigeria to 70.6% in rural West Nile, Uganda. It was higher in males and rural areas.
  
  
  CONCLUSIONS
  Our data indicate that geographical exposures, gender, age, and factors correlated with rural residence impact HHV-8 seropositivity in sub-Saharan Africa.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA. pfeiffer@mail.nih.gov
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: William A
authors.initials: WA
authors.lastname: Wheeler
authors.forename: Georgina
authors.initials: G
authors.lastname: Mbisa
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: Guy
authors.initials: G
authors.lastname: de Thé
authors.forename: Sam M
authors.initials: SM
authors.lastname: Mbulaiteye
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005843:Geography; D006566:Herpesviridae Infections / Q000097:blood* / Q000453:epidemiology*; D019288:Herpesvirus 8, Human / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012514:Sarcoma, Kaposi; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral