Blood-Borne and Sexual Transmission of Human Herpesvirus 8 in Women with or at Risk for Human Immunodeficiency Virus Infection
Michael J. Cannon, Ph.D., Sheila C. Dollard, Ph.D., Dawn K. Smith, M.D., Robert S. Klein, M.D., Paula Schuman, M.D., M.P.H., Josiah D. Rich, M.D., M.P.H., David Vlahov, Ph.D., Philip E. Pellett, Ph.D., for The HIV Epidemiology Research Study Group
Background Human herpesvirus 8 (HHV-8), the causal agent ofKaposi's sarcoma, is transmitted sexually among homosexual men,but little is known of its transmission among women. AlthoughHHV-8 has been detected in blood, there has been no clear evidenceof blood-borne transmission.
Methods We identified risk factors for HHV-8 infection in 1295women in Baltimore, Detroit, New York, and Providence, RhodeIsland, who reported high-risk sexual behavior or drug use.HHV-8 serologic studies were performed with two enzyme-linkedimmunosorbent assays.
Results In univariate analyses, HHV-8 was associated with blackrace, Hispanic ethnic background, a lower level of education,and infection with syphilis, the human immunodeficiency virus(HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV).The risk of seropositivity for HHV-8 increased with the frequencyof injection-drug use (P<0.001); HHV-8 seroprevalence amongthe women who used drugs daily was three times that among womenwho never injected drugs. Among the women with a low risk ofsexual transmission, HHV-8 seroprevalence was 0 percent in thosewho had never injected drugs and 36 percent in those who hadinjected drugs (P<0.001). However, injection-drug use waslinked less strongly to HHV-8 infection than to infection withHBV or HCV. In a multivariate analysis, independent predictorsof HHV-8 seropositivity included HIV infection (odds ratio,1.6; 95 percent confidence interval, 1.1 to 2.2), syphilis infection(odds ratio, 1.8; 95 percent confidence interval, 1.1 to 2.8),and daily injection-drug use (odds ratio, 3.2; 95 percent confidenceinterval, 1.4 to 7.6).
Conclusions Both injection-drug use and correlates of sexualactivity were risk factors for HHV-8 infection in the womenstudied. The independent association of HHV-8 infection withinjection-drug use suggests that HHV-8 is transmitted throughneedle sharing, albeit less efficiently than HBV, HCV, or HIV.
Source Information
From the Centers for Disease Control and Prevention, Atlanta (M.J.C., S.C.D., D.K.S., P.E.P.); Rollins School of Public Health, Emory University, Atlanta (M.J.C.); the Division of Infectious Diseases, Department of Medicine, and the Department of Epidemiology and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, N.Y. (R.S.K.); the Division of Infectious Diseases, School of Medicine, Wayne State University, Detroit (P.S.); Brown University, Providence, R.I. (J.D.R.); and the Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, and the New York Academy of Medicine, New York (D.V.).
Address reprint requests to Dr. Pellett at the Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop G18, Atlanta, GA 30333, or at ppellett{at}cdc.gov.
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