Prevalence of infection with human herpesvirus 8/Kaposi's sarcoma herpesvirus in rural South Africa

Objective. To determine prevalence of infection with human herpesvirus 8 (HHV-8)/Kaposi's sarcoma herpesvirus (KSHY) and to gain some insight into possible transmission dynamics of this novel virus in South Africa.Methods. Stored, anonymous serum from 50 patients with a ~ sexually transmitted disease (STD), 50 adult medical ward _. patients (25 male, 25 female), and 36 paediatric ward patients in Hlabisa Hospital, KwaZulu-Natal, was screened by enzyme-linked immunosorbent assay (ELISA) for antibodies to the small capsid-related protein encoded by HHV-8/KSHY orf65. Antibodies to the latency-associated nuclear antigen (LANA) were measured by immunofluorescence, and sera that were reactive in the ELISA but negative by immunofluorescence were re-tested by Western blot against the recombinant orf65 protein to exclude nonspecific reactivity.Results. Overall, 47 patients tested positive (34.6%), 76 tested negative (55.9%) and 13 (95%) had indeterminate results. Among those with a definite result, prevalence was similar among males (47.2%) and females (52.8%) and increased in later adulthood « 18 months 375%,19 -120 months 385%, 15 - 34 years 32.1%, 35 - 69 years 62.8%). Prevalence was highest among medical patients (58-1%); among those with an STD it was 31.1% (P = 0-01), and among children it was 22.8% (P = 0.001). When age-adjusted, prevalence among medical patients (23.7%) was similar to that among patients with an STD.Conclusion. Prevalence of HHV-8/KSHY is high in this setting and transmission appears to be occurring in childhood as well as among adults. Larger population-based studies are required to detail the transmission dynamics of HHSV8/KSHv