Crabtree Kay L, Wojcicki Janet M, Minhas Veenu, Kankasa Chipepo, Mitchell Charles, Wood Charles
Nebraska Center for Virology and the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska.
Department of Biomedical Sciences, Bryan College of Health Sciences, Lincoln.
J Infect Dis. 2017 Oct 17;216(7):842-849. doi: 10.1093/infdis/jix399.
Human herpesvirus 8 (HHV-8) infection occurs in early childhood and is associated with human immunodeficiency virus type 1 (HIV-1) infection and risk for Kaposi sarcoma, but behaviors associated with HHV-8 transmission are not well described.
We enrolled and followed a prospective cohort of 270 children and their household members to investigate risk factors for HHV-8 transmission in Lusaka, Zambia.
We report an incidence of 30.07 seroconversions per 100 child-years. Independent risk factors for HHV-8 incident infection included having a child who shared utensils with a primary caregiver (hazards ratio [HR], 2.33; 95% confidence interval [CI], 1.49-7.14), having an increasing number of HHV-8-infected household members (HR, 1.27; 95% CI, 1.09-2.79), and having ≥5 siblings/children in the household (HR, 2.24; 95% CI, 1.03-4.88). Playing with >5 children a day was protective against infection (HR, 0.54; 95% CI, .33-0.89), as was increasing child age (HR, 0.96; 95% CI, .93-.99).
This is the first study to find a temporal association between limited child feeding behaviors and risk for HHV-8 infection. Child food- and drink-sharing behaviors should be included in efforts to minimize HHV-8 transmission, and households with a large number of siblings should receive additional counseling as childhood infections occur in the home context.
人类疱疹病毒8型（HHV-8）感染发生于儿童早期，与1型人类免疫缺陷病毒（HIV-1）感染及卡波西肉瘤风险相关，但与HHV-8传播相关的行为尚无详尽描述。
我们招募并随访了270名儿童及其家庭成员组成的前瞻性队列，以调查赞比亚卢萨卡HHV-8传播的危险因素。
我们报告每100儿童年有30.07次血清转化发生率。HHV-8感染的独立危险因素包括有与主要照料者共用器具的儿童（风险比[HR]，2.33；95%置信区间[CI]，1.49 - 7.14）、HHV-8感染的家庭成员数量增加（HR，1.27；95% CI，1.09 - 2.79）以及家庭中有≥5个兄弟姐妹/儿童（HR，2.24；95% CI，1.03 - 4.88）。每天与>5名儿童玩耍可预防感染（HR，0.54；95% CI，0.33 - 0.89），儿童年龄增长也有同样效果（HR，0.96；95% CI，0.93 - 0.99）。
这是第一项发现儿童喂养行为受限与HHV-8感染风险之间存在时间关联的研究。为尽量减少HHV-8传播，应将儿童食物和饮料共享行为纳入防控措施，并且对于兄弟姐妹众多的家庭，鉴于儿童感染在家中发生，应给予额外的咨询指导。
