title: Risk factors for Kaposi's sarcoma among HIV-positive individuals in a case control study in Cameroon.
abstract: BACKGROUND
  Individuals co-infected with Kaposi's sarcoma herpesvirus (KSHV) and Human Immunodeficiency Virus (HIV) are at greatly increased risk of developing Kaposi's sarcoma (KS). The objective of the current analysis is to identify risk cofactors for KS among HIV-positive individuals.
  
  
  METHODS
  We conducted a case-control study of KS in Cameroon on 161 HIV-positive and 14 HIV-negative cases and 680 HIV-positive and 322 HIV-negative controls. Participants answered a physician-administered questionnaire and provided blood and saliva specimens. Antibodies against KSHV lytic, K8.1, and latent, ORF73, antigens were measured by ELISA to determine KSHV serostatus. Conditional logistic regression was performed to determine multivariate odds ratios (OR) and 95% confidence intervals (CI) for risk factors associated with KS among HIV-positive cases and controls.
  
  
  RESULTS
  Overall, 98% (158) of HIV-positive cases, 100% (14) of HIV-negative cases, 81% (550) of HIV-positive controls, and 80% (257) of HIV-negative controls were KSHV seropositive. Risk factors for KS among HIV-positive individuals included KSHV seropositivity (OR=9.6; 95% CI 2.9, 31.5), non-use of a mosquito bed net (OR 1.9; 95% CI 1.2, 2.9), minority ethnicity (OR=3.1; 95% CI 1.1, 9.3), treatment from a traditional healer (OR=2.3; 95% CI 1.5, 3.7), history of transfusion (OR=2.4; 95% CI 1.5, 3.9), and family history of cancer (OR=1.9; 95% CI 1.1, 3.1).
  
  
  CONCLUSIONS
  KSHV seroprevalence of ≥80% indicates a high prevalence in the general population in Cameroon. Among HIV-positive individuals, the strong association of KS with non-use of mosquito nets and treatment from traditional healers are compelling findings, consistent with recently reported data from East Africa.
authors.affiliation: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, United States. Electronic address: kstolka@rti.org.
authors.forename: Kristen
authors.initials: K
authors.lastname: Stolka
authors.affiliation: SOCHIMIO, Rue EMIA, après Gendarmerie Nationale, Box 25513, Yaoundé, Cameroon.
authors.forename: Paul
authors.initials: P
authors.lastname: Ndom
authors.affiliation: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hemingway-Foday
authors.affiliation: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, United States.
authors.forename: Jeniffer
authors.initials: J
authors.lastname: Iriondo-Perez
authors.affiliation: Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, BLDG 535, 4th floor, Frederick, MD 21702, United States.
authors.forename: Wendell
authors.initials: W
authors.lastname: Miley
authors.affiliation: Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, BLDG 535, 4th floor, Frederick, MD 21702, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, United States.
authors.forename: Nazzarena
authors.initials: N
authors.lastname: Labo
authors.affiliation: University of California, 55 Laguna Street, San Francisco, CA 94102, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Stella
authors.affiliation: Expanded Program on Immunization, BP 186, Garoua, Cameroon.
authors.forename: Mahamat
authors.initials: M
authors.lastname: Abassora
authors.affiliation: Expanded Program on Immunization, BP 186, Garoua, Cameroon; Elizabeth Glaser Pediatric AIDS Foundation, 1140 Connecticut Avenue NW, Washington, DC 20036, United States.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Woelk
authors.affiliation: University of California, 200 West Arbor Drive #8485, San Diego, CA 92103, United States.
authors.forename: Robin
authors.initials: R
authors.lastname: Ryder
authors.affiliation: Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, BLDG 535, 4th floor, Frederick, MD 21702, United States.
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
authors.affiliation: 2103 McGavran-Greenberg, Department of Epidemiology, University of North Carolina at Chapel Hill, Campus Box 7435, Chapel Hill, NC 27599, United States.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
mesh_terms: D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult
keywords: Cameroon; Human Immunodeficiency Virus (HIV); Human herpesvirus 8 (HHV-8); Kaposi's sarcoma (KS); Kaposi's sarcoma herpesvirus (KSHV); Risk factors