First survey for detecting the presence of human herpesvirus 8 infection (HHV-8) in Maputo, Mozambique

Abstract

Human herpesvirus 8 (HHV-8), the etiological agent of Kaposi's sarcoma (KS), is endemic in parts of the subSaharan, and KS has increased concomitantly with the HIV/AIDS epidemic. In Mozambique (MZ), no data concerning HHV-8 infection was available, thus the main of this work was to investigate, for the first time, the presence of HHV-8 infection in Maputo, MZ. Latent and lytic HHV-8-specific antibodies were assessed in blood samples from 189 individuals from the Central Hospital of Maputo, MZ, using "in-house" immunofluorescence assays conducted in São Paulo, Brazil. The results obtained were analyzed according to socio-demographic and clinical variables using the Chi-square test and logistic regression. An HHV-8 seropositivity of 1.8% and 9.7% was detected among 57 medical students and 31 individuals from the staff, respectively, in contrast to 16.4% detected among 67 out-patients. Concerning 34 hospitalized patients from the Dermatology Unit, 47.1% were HHV-8-seropositive overall, while the rate was 85.7% among KS patients. The present survey, conducted in Maputo, MZ, demonstrates great variation in HHV-8 infection frequencies depending on the group analyzed and epidemiological variables. An association between HHV-8 seropositivity and male gender (OR 5.72), the central origin of patients (OR 5.33), blood transfusions (OR 3.25), and KS (OR 24.0) was detected among hospitalized patients, and primary school (OR 7.18) and HIV-1 infection (OR 8.76) among out-patients.

Seroprevalence of human herpesvirus 8 infection in individuals from health care centers in Mozambique: Potential for endemic and epidemic Kaposi's sarcoma

“…Few data are available on the seroprevalence of and risk factors associated with HHV-8 infection in Mozambique. Only two preliminary studies have been conducted, and these studies present different results [Ceffa et al, 2007;Caterino-de-Araujo et al, 2009]. The reported heterogeneity in HHV-8 seroprevalence could be an artifact resulting from interlaboratory variability in the assays or may be due to variability in the age or characteristics of the analyzed population.…”

“…In fact, all of these variables could account for the discordant results that have been reported. For instance, one study used an ELISA that is available commercially to detect HHV-8 antibodies [Ceffa et al, 2007]; the other used an ''in house'' immunofluorescence assay [Caterino-de-Araujo et al, 2009]. In addition, differences in the characteristics of the participants, including age and gender and socioeconomic, demographic and clinical variables were observed between the studies.…”

“…In these outpatients, HHV-8 seropositivity could be correlated with having only a primary school education and HIV infection. Among 34 hospitalized patients from the Dermatology Unit, 47.1% were HHV-8-seropositive and associations between HHV-8 seropositivity and gender, native to Central region, prior blood transfusions, and KS were observed [Caterino-de-Araujo et al, 2009]. To confirm and extend these preliminary data, the present study was undertaken with the following objectives: (i) to evaluate the seroprevalence of HHV-8 infection in individuals attending public health care centers in Northern, Central and Southern Mozambique, regions where the HIV infection rate varies considerably; (ii) to identify any association between HHV-8 infection and socioeconomic, demographic or clinical variables; and (iii) to speculate on HHV-8 and HIV infections in endemic and epidemic KS outbreaks when preventive transmission measurements may not be introduced and ARV therapy may not be available universally or could be interrupted.…”

Patterns of antibodies against latent and lytic antigens of human herpesvirus 8 in an endemic population and patients with Kaposi's sarcoma in Mozambique

“…An immunofluorescence assay (IFA) that detects antibodies specific for latent antigens (IFA‐LANA) has long been considered a reference serological test to detect HHV‐8 infection [Martin et al, 2000], and an IFA to detect lytic antigens (IFA‐Lytic) has been used in epidemiological surveys [Rezza et al, 1998; Leão et al, 2002; Pérez et al, 2006; Mohanna et al, 2007]. The Immunology Department of the Instituto Adolfo Lutz, a Public Health Laboratory in São Paulo, Brazil, has used these assays to identify at‐risk populations [Caterino‐de‐Araujo and Cibella, 2003; Cunha et al, 2005; Avelleira et al, 2006; Caterino‐de‐Araujo et al, 2003, 2007a,b, 2009; Magri et al, 2008] and to compare the frequency and titer of antibodies against latent and lytic antigens of HHV‐8 in clinically interesting populations [Magri et al, 2009]. These studies have identified high‐risk groups and patterns of antibodies for HHV‐8 of predictive value.…”