title: Is human herpesvirus 8 infection more common in men than in women? Systematic review and meta-analysis.
abstract: All forms of Kaposi sarcoma (KS) are more common in men than in women. It is unknown if this is due to a higher prevalence of human herpesvirus 8 (HHV-8), the underlying cause of KS, in men compared to women. We did a systematic review and meta-analysis to examine the association between HHV-8 seropositivity and gender in the general population. Studies in selected populations like for example, blood donors, hospital patients and men who have sex with men were excluded. We searched Medline and Embase from January 1994 to February 2015. We included observational studies that recruited participants from the general population and reported HHV-8 seroprevalence for men and women or boys and girls. We used random-effects meta-analysis to pool odds ratios (OR) of the association between HHV-8 and gender. We used meta-regression to identify effect modifiers, including age, geographical region and type of HHV-8 antibody test. We included 22 studies, with 36,175 participants. Men from sub-Saharan Africa (SSA) [OR 1.21, 95% confidence interval (CI) 1.09-1.34], but not men from elsewhere (OR 0.94, 95% CI 0.83-1.06), were more likely to be HHV-8 seropositive than women (p value for interaction = 0.010). There was no difference in HHV-8 seroprevalence between boys and girls from SSA (OR 0.90, 95% CI 0.72-1.13). The type of HHV-8 assay did not affect the overall results. A higher HHV-8 seroprevalence in men than women in SSA may partially explain why men have a higher KS risk in this region.
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Lorin
authors.initials: L
authors.lastname: Begré
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Eliane
authors.initials: E
authors.lastname: Rohner
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
authors.forename: Sam M
authors.initials: SM
authors.lastname: Mbulaiteye
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.|Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Bohlius
mesh_terms: D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006566:Herpesviridae Infections / Q000453:epidemiology* / Q000821:virology; D019288:Herpesvirus 8, Human; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology; D016036:Seroepidemiologic Studies; D012737:Sex Factors
keywords: Kaposi sarcoma; gender; human herpesvirus 8; meta-analysis; seroprevalence