Prevalence of Kaposi sarcoma-associated herpesvirus compared with selectedsexually transmitted diseases in adolescents and young adults in rural Rakai District, Uganda

Background: Kaposi sarcoma-associated herpesvirus (KSHV) is transmitted by routes such as homosexual intercourse and is associated with HIV infection in industrialized countries. However, there is little information about its transmission in developing countries where Kaposi sarcoma is an endemic di sease. Goal: To examine KSHV seroprevalence in young adults in a general, rural Ug andan population, and to compare this prevalence with rates of known sexual ly transmitted infections. Study Design: The seroprevalence of KSHV was compared with the epidemiology of sexually transmitted diseases in 523 sexually active subjects aged 15 t o 29 years who were randomly selected from a general population cohort in r ural Rakai District, Uganda, Participants provided in-home interview data a nd specimens. Sera were tested for KSHV using immunofluorescence assay and immunoblot for lytically expressed recombinant KSHV ORF65.2. Sera were also tested for HIV type 1, herpes simplex virus type 2, and syphilis. Results: The prevalence of KSHV was significantly higher in participants 15 to 19 years compared with older persons 25 to 29 years (45.0% and 36.1%, r espectively; adjusted odds ratio, 0.48; 95% CI, 0,28-0.82), In contrast, he rpes simplex virus type 2 and HIV type 1 prevalence increased with age. Kap osi sarcoma-associated herpesvirus serostatus was not associated with HIV t ype 1, syphilis, herpes simplex virus type 2or number of sexual partners, H omosexual and anal intercourse were reported by less than 1% of participant s. Conclusions: Kaposi sarcoma-associated herpesvirus does not appear to be a heterosexually transmitted infection in rural Uganda.