Hladik Wolfgang, Dollard Sheila C, Mermin Jonathan, Fowlkes Ashley L, Downing Robert, Amin Minal M, Banage Flora, Nzaro Esau, Kataaha Peter, Dondero Timothy J, Pellett Philip E, Lackritz Eve M
Global Acquired Immunodeficiency Syndrome Program, National Center for Human Immunodeficiency Virus, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Entebbe, Uganda.
N Engl J Med. 2006 Sep 28;355(13):1331-8. doi: 10.1056/NEJMoa055009.
Whether human herpesvirus 8 (HHV-8) is transmissible by blood transfusion remains undetermined. We evaluated the risk of HHV-8 transmission by blood transfusion in Uganda, where HHV-8 is endemic.
We enrolled patients in Kampala, Uganda, who had received blood transfusions between December 2000 and October 2001. Pretransfusion and multiple post-transfusion blood specimens from up to nine visits over a 6-month period were tested for HHV-8 antibody. We calculated the excess risk of seroconversion over time among recipients of HHV-8-seropositive blood as compared with recipients of seronegative blood.
Of the 1811 transfusion recipients enrolled, 991 were HHV-8-seronegative before transfusion and completed the requisite follow-up, 43% of whom received HHV-8-seropositive blood and 57% of whom received seronegative blood. HHV-8 seroconversion occurred in 41 of the 991 recipients. The risk of seroconversion was significantly higher among recipients of HHV-8-seropositive blood than among recipients of seronegative blood (excess risk, 2.8%; P<0.05), and the increase in risk was seen mainly among patients in whom seroconversion occurred 3 to 10 weeks after transfusion (excess risk, 2.7%; P=0.005), a result consistent with the transmission of the virus by transfusion. Blood units stored for up to 4 days were more often associated with seroconversion than those stored for more than 4 days (excess risk, 4.2%; P<0.05).
This study provides strong evidence that HHV-8 is transmitted by blood transfusion. The risk may be diminished as the period of blood storage increases.
人类疱疹病毒8型(HHV-8)是否可通过输血传播仍未确定。我们在HHV-8为地方病的乌干达评估了输血传播HHV-8的风险。
我们纳入了2000年12月至2001年10月期间在乌干达坎帕拉接受输血的患者。在6个月内最多9次访视时采集输血前和多次输血后的血标本,检测HHV-8抗体。我们计算了与接受HHV-8血清阴性血液的受血者相比,接受HHV-8血清阳性血液的受血者随时间发生血清转化的额外风险。
在纳入的1811名输血受血者中,991名在输血前为HHV-8血清阴性并完成了必要的随访,其中43%接受了HHV-8血清阳性血液,57%接受了血清阴性血液。991名受血者中有41名发生了HHV-8血清转化。接受HHV-8血清阳性血液的受血者血清转化风险显著高于接受血清阴性血液的受血者(额外风险为2.8%;P<0.05),风险增加主要见于输血后3至10周发生血清转化的患者(额外风险为2.7%;P=0.005),这一结果与病毒通过输血传播一致。储存长达4天的血液单位比储存超过4天的血液单位更常与血清转化相关(额外风险为4.2%;P<0.