Prevalence, incidence and correlates of HHV-8/KSHV infection and Kaposi's sarcoma in renal and liver transplant recipients

Background: To determine whether the incidence of HHV-8/KSHV infection and the risk of developing KS among organ transplant recipients differ by type of organ transplanted, we calculated the rate of HHV-8/KSHV seroconversion and the risk of developing KS among renal and liver transplant recipients. Methods: The study population consisted of renal and liver transplant recip ients recruited in two transplant centres in Rome, Italy. Both pre-transpla nt and post-transplant serum samples were available for all participants. T he prevalence of HHV-8/KSHV infection before transplantation was calculated . To determine risk factors for infection, we calculated ORs and 95% CI. Se roconversion rates (i.e. attack rates) after transplantation were also calc ulated. Differences in attack rates were calculated using a binomial test f or proportions. Results: Of the 130 participants, 21 (16.1%) were HHV-8/KSHV-positive befor e transplantation. Women were more likely to be infected than men, whereas no difference was observed by type of organ transplanted. Of the 109 initia lly negative individuals, 13 (11.9%) developed anti-HHV-8/KSHV antibodies a fter transplantation. The incidence of HHV-8/KSHV infection tended to be hi gher among liver transplant recipients. Four renal transplant recipients an d none of the liver transplant recipients developed KS after transplantatio n. The risk of KS was higher among recipients who were already HHV-8/KSHV-p ositive before transplantation. Conclusions: HHV-8/KSHV seroconversion rates appear to be higher among live r transplant recipients, compared to renal transplant recipients. However, renal transplant recipients tend to have a higher risk of KS. HHV-8/KSHV re activation appears to play a greater role on the risk of KS than incident i nfections. (C) 2001 The British Infection Society.