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

Objective. To determine prevalence of infection wit human herpesvirus 8 (HH V-8)/Kaposi's sarcoma herpesvirus (KSHV) and to gain some insight into poss ible transmission dynamics of this novel virus in South Africa. Methods. Stored, anonymous serum from 50 patients with a sexually transmitt ed disease (STD), 50 adult medical ward patients (25 male, 25 female), and 36 paediatric ward patients in Hlabisa Hospital, KwaZulu-Natal, was screene d by enzyme-linked immunosorbent assay (ELISA) for antibodies to the small capsid-related protein encoded by HHV-8/KSHV orf65. Antibodies to the laten cy-associated nuclear antigen(LANA) were measured by immunofluorescence, an d sera that were reactive in the ELISA but negative by immunofluorescence w ere re-tested by Western blot against the recombinant orf65 protein to excl ude nonspecific reactivity. Results. Overall, 47 patients tested positive (34.6%), 76 tested negative ( 55.9%) and 13 (9.5%) had indeterminate results. Among those wit a definite result, prevalence was similar among males (47.2%) and females (52.8%) and increased in later adulthood (<18 months 37.5%, 19 - 120 months 38.5%, 15 - 34 years 32.1% 35 - 69 years 62.8%). Prevalence was highest among medical patients (58.1%); among those with with an STD it was 31.1% (P = 0.01), and among children it was 22.8% (P = 0.001). When age-adjusted, prevalence amo ng medical patients (23.7%) was similar to that among patients with an STD. Conclusion. Prevalence of HHV-8/KSHV is high in this setting and transmissi on appears to be occurring in childhood as well as among adults. Larger pop ulation-based studies are required to detail the transmission dynamics of H HSV-8/KSHV.