Mbulaiteye Sam M, Biggar Robert J, Bakaki Paul M, Pfeiffer Ruth M, Whitby Denise, Owor Anchilla M, Katongole-Mbidde Edward, Goedert James J, Ndugwa Christopher M, Engels Eric A
Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
J Natl Cancer Inst. 2003 Sep 3;95(17):1330-5. doi: 10.1093/jnci/djg039.
Although human herpesvirus 8 (HHV-8), the etiologic agent for Kaposi's sarcoma, can be detected in peripheral blood, blood-borne transmission of this virus has not been demonstrated. We studied the association between HHV-8 seropositivity and transfusion history among children with sickle-cell disease in Uganda, where HHV-8 infection is common in blood donors.
We studied 600 children (aged 0-16 years) with sickle-cell disease at Mulago Hospital, Kampala, from November 2001 through April 2002. By design, about half had previously been transfused. HHV-8 serostatus was determined using enzyme-linked immunosorbent assays for antibodies against HHV-8 proteins K8.1 and orf 73. We used logistic regression to test for an association between HHV-8 serostatus and transfusion history and a Markov model to estimate the transmission risk per transfusion and the cumulative risk from community (i.e., nontransfusion) sources. Statistical tests were two-sided.
HHV-8 antibodies were detected in 117 of 561 (21%) children with unambiguous K8.1 results. HHV-8 seroprevalence among the never-transfused children increased with age from 7% in children aged 0-2 years to 32% in those aged 13-16 years (P(trend)<.001). HHV-8 seropositivity was more frequent in transfused than never-transfused children (24% versus 17%, odds ratio = 1.48, 95% confidence interval [CI] = 0.97 to 2.26; P =.07). Seropositivity increased with number of reported transfusions, with age-adjusted odds ratios of 0.97 (95% CI = 0.54 to 1.75), 1.13 (95% CI = 0.59 to 2.17), 1.76 (95% CI = 0.81 to 3.83), and 2.17 (95% CI = 1.18 to 3.99) for children with one, two, three, or four or more transfusions, respectively (P(trend) =.007). Overall, the estimated HHV-8 transmission risk was 2.6% per transfusion (95% CI = 1.9% to 3.3%), whereas the annual risk of infection unrelated to transfusion was 2.7% (95% CI = 1.7% to 3.7%).
Our study suggests that blood transfusion is associated with a small risk of HHV-8 transmission. In Uganda, this risk is approximately equivalent to the 1-year cumulative risk of infection from community sources.
虽然人类疱疹病毒8型（HHV - 8）是卡波西肉瘤的病原体，可在外周血中检测到，但该病毒的血源性传播尚未得到证实。我们研究了乌干达镰状细胞病患儿中HHV - 8血清阳性与输血史之间的关联，在乌干达，献血者中HHV - 8感染很常见。
2001年11月至2002年4月，我们在坎帕拉穆拉戈医院研究了600名年龄在0至16岁的镰状细胞病患儿。按照设计，约一半患儿此前接受过输血。采用酶联免疫吸附试验检测针对HHV - 8蛋白K8.1和orf 73的抗体来确定HHV - 8血清状态。我们使用逻辑回归检验HHV - 8血清状态与输血史之间的关联，并使用马尔可夫模型估计每次输血的传播风险以及来自社区（即非输血）来源的累积风险。统计检验为双侧检验。
在561名K8.1结果明确的患儿中，117名（21%）检测到HHV - 8抗体。未输血患儿中HHV - 8血清阳性率随年龄增长而升高，从0至2岁患儿中的7%升至13至l6岁患儿中的32%（趋势P值<.001）。输血患儿的HHV - 8血清阳性率高于未输血患儿（24%对17%，比值比 = 1.48，95%置信区间[CI] = 0.97至2.26；P = 0.07）。血清阳性率随报告的输血量增加而升高，接受一次、两次、三次或四次及以上输血患儿的年龄调整后比值比分别为0.97（95%CI = 0.54至l.75）、1.13（95%CI = 0.59至2.17）、1.76（95%CI = 0.81至3.83）和2.17（95%CI = 1.18至3.99）（趋势P值 = 0.007）。总体而言，估计的HHV - 8每次输血传播风险为2.6%（95%CI = 1.9%至3.3%），而与输血无关的年度感染风险为2.7%（95%CI = 1.7%至3.7%）。
我们的研究表明输血与HHV - 8传播的小风险相关。在乌干达，这种风险大约相当于来自社区来源的1年累积感染风险。
