title: Risk factors for early childhood infection of human herpesvirus-8 in Zambian children: the role of early childhood feeding practices.
abstract: BACKGROUND
  Human herpesvirus-8 (HHV-8) infection in early childhood is common throughout sub-Saharan Africa with prevalence increasing throughout childhood. Specific routes of transmission have not been clearly delineated, though HHV-8 is present in high concentrations in saliva.
  
  
  METHODS
  To understand the horizontal transmission of HHV-8 within households to children, we enrolled for cross-sectional analysis, 251 households including 254 children, age two and under, in Lusaka, Zambia. For all children, plasma was screened for HHV-8 and HIV type I (HIV-1) and health and behavioral questionnaires were completed. Multilevel logistic regression analysis was conducted to assess independent factors for HHV-8 infection in children.
  
  
  RESULTS
  Risk factors for HHV-8 infection included increasing number of HHV-8-positive household members [OR = 2.5; 95% confidence interval (CI), 1.9-3.3; P < 0.01] and having a primary caregiver who tested the temperature of food with their tongue before feeding the child (OR = 2.4; 95% CI, 1.93-3.30; P = 0.01). Breastfeeding was protective against infection with HHV-8 for children (OR = 0.3; 95% CI, 0.16-0.72; P < 0.01).
  
  
  CONCLUSIONS
  These results indicate that exposure to HHV-8 in the household increases risk for early childhood infection, with specific feeding behaviors likely playing a role in transmission.
  
  
  CONCLUSIONS
  Interventions to protect children from infection should emphasize the possibility of infection through sharing of foods.
authors.affiliation: Authors' Affiliations: Nebraska Center for Virology and School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska; Department of Pediatrics, University of California, San Francisco, California; Department of Pathobiology and Population Medicine, Mississippi State University, Mississippi State, Mississippi; University of Zambia, School of Medicine and University Teaching Hospital, Zambia; and University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Kay L
authors.initials: KL
authors.lastname: Crabtree
authors.forename: Janet M
authors.initials: JM
authors.lastname: Wojcicki
authors.forename: Veenu
authors.initials: V
authors.lastname: Minhas
authors.forename: David R
authors.initials: DR
authors.lastname: Smith
authors.forename: Chipepo
authors.initials: C
authors.lastname: Kankasa
authors.forename: Charles D
authors.initials: CD
authors.lastname: Mitchell
authors.forename: Charles
authors.initials: C
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005191:Family Characteristics; D005247:Feeding Behavior; D005260:Female; D006566:Herpesviridae Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry / Q000821:virology; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology