Risk factors for high anti-HHV-8 antibody titers (> or =1:51,200) in black, HIV-1 negative South African cancer patients: a case control study

BMC Infect Dis. 2003 Sep 12:3:21. doi: 10.1186/1471-2334-3-21.

Abstract

Background: Infection with human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), is the necessary causal agent in the development of Kaposi's sarcoma (KS). Infection with HIV-1, male gender and older age all increase risk for KS. However, the geographic distribution of HHV-8 and KS both prior to the HIV/AIDS epidemic and with HIV/AIDS suggest the presence of an additional co-factor in the development of KS.

Methods: Between January 1994 and October 1997, we interviewed 2576 black in-patients with cancer in Johannesburg and Soweto, South Africa. Blood was tested for antibodies against HIV-1 and HHV-8 and the study was restricted to 2191 HIV-1 negative patients. Antibodies against the latent nuclear antigen of HHV-8 encoded by orf73 were detected with an indirect immunofluorescence assay. We examined the relationship between high anti-HHV-8 antibody titers (> or =1:51,200) and sociodemographic and behavioral factors using unconditional logistic regression models. Variables that were significant at p = 0.10 were included in multivariate analysis.

Results: Of the 2191 HIV-1 negative patients who did not have Kaposi's sarcoma, 854 (39.0%) were positive for antibodies against HHV-8 according to the immunofluorescent assay. Among those seropositive for HHV-8, 530 (62.1%) had low titers (1:200), 227 (26.6%) had medium titers (1:51,200) and 97 (11.4%) had highest titers (1:204,800). Among the 2191 HIV-1 negative patients, the prevalence of high anti-HHV-8 antibody titers (> or =1:51,200) was independently associated with increasing age (p-trend = 0.04), having a marital status of separated or divorced (p = 0.003), using wood, coal or charcoal as fuel for cooking 20 years ago instead of electricity (p = 0.02) and consuming traditional maize beer more than one time a week (p = 0.02; p-trend for increasing consumption = 0.05) although this may be due to chance given the large number of predictors considered in this analysis.

Conclusions: Among HIV-negative subjects, patients with high anti-HHV-8 antibody titers are characterized by older age. Other associations that may be factors in the development of high anti-HHV-8 titers include exposure to poverty or a low socioeconomic status environment and consumption of traditional maize beer. The relationship between these variables and high anti-HHV-8 titers requires further, prospective study.

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Antibodies, Viral / blood*
  • Case-Control Studies
  • Female
  • HIV Seronegativity
  • HIV-1 / immunology*
  • Herpesvirus 8, Human / immunology*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sarcoma, Kaposi / epidemiology*
  • Sarcoma, Kaposi / immunology
  • Sarcoma, Kaposi / virology
  • South Africa

Substances

  • Antibodies, Viral