title: High seroprevalence of antibodies against Kaposi's sarcoma-associated herpesvirus (KSHV) among HIV-1-infected children and adolescents in a non-endemic population.
abstract: Human herpesvirus-8 (HHV-8) is the etiological agent of Kaposi's sarcoma (KS), which primarily affects human immunodeficiency virus (HIV)-infected adults with advanced immunodeficiency. Currently, only limited prevalence data for HHV-8 infection in HIV-infected children living in non-endemic areas are available. This multicenter cross-sectional study was conducted in four university hospitals in Germany specializing in pediatric HIV care. Stored serum specimens obtained from 207 vertically HIV-1-infected children and adolescents were tested for antibodies against lytic and latent HHV-8 antigens. Logistic regression was used to assess independent risk factors associated with HHV-8 seropositivity. The overall HHV-8 seroprevalence was 24.6 % (n = 51/207) without significant differences related to sex, age, or ethnicity. In univariate analysis, HHV-8 seropositivity was significantly associated with a child having being born outside Germany, maternal origin from sub-Saharan Africa, a history of breastfeeding, CDC immunologic category 3, and deferred initiation of antiretroviral therapy (>24 months of age). In multivariate analysis, a child's birth outside Germany was the only significant risk factor for HHV-8 seropositivity (odds ratio 3.98; 95 % confidence interval 1.27-12.42). HHV-8-associated malignancies were uncommon; only one patient had a history of KS. Serum specimen of vertically HIV-infected children and adolescents living in Germany showed a high HHV-8 seroprevalence. These findings suggest that primary HHV-8 infection-a risk factor for KS and other HHV-8-associated malignancies-occurs early in life. Thus, management of perinatally HIV-infected children should include testing for HHV-8 coinfection and should consider future risks of HHV-8-associated malignancies.
authors.affiliation: Department of Pediatric Pneumology and Immunology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. cornelia.feiterna-sperling@charite.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Feiterna-Sperling
authors.affiliation: Department of Pediatrics, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Königs
authors.affiliation: Ludwig-Maximilians-University of Munich, Dr. von Haunersches Kinderspital, Munich, Germany.
authors.forename: Gundula
authors.initials: G
authors.lastname: Notheis
authors.affiliation: Medical Faculty Mannheim, University Children's Hospital, Heidelberg University, Heidelberg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Buchholz
authors.affiliation: Department of Pediatric Pneumology and Immunology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Krüger
authors.affiliation: Department of Obstetrics, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Weizsäcker
authors.affiliation: Max von Pettenkofer-Institut, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Eberle
authors.affiliation: German Association of Physicians in HIV Care, Berlin, Germany.
authors.forename: Nikola
authors.initials: N
authors.lastname: Hanhoff
authors.affiliation: Institute of Microbiology and Hygiene, University of Saarland Medical School, Homburg/Saar, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gärtner
authors.affiliation: Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Heider
authors.affiliation: Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: Detlev H
authors.initials: DH
authors.lastname: Krüger
authors.affiliation: Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Hofmann
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006566:Herpesviridae Infections / Q000453:epidemiology* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral
keywords: HHV-8; HIV-1; Human herpesvirus-8; KSHV; Kaposi’s sarcoma; Kaposi’s sarcoma-associated herpesvirus; Pediatric patients