HHV-8 Seroprevalence and Genotype Distribution in Africa, 1998–2017: A Systematic Review

Abstract

Human herpes virus type 8 (HHV-8) is the causative agent of Kaposi’s sarcoma (KS). We systematically reviewed literature published between 1998 and 2017, according to the PRISMA guidelines, to understand the distribution of HHV-8 infection in Africa. More than two-thirds (64%) of studies reported on seroprevalence and 29.3% on genotypes; 9.5% were on both seroprevalence and genotypes. About 45% of African countries had data on HHV-8 seroprevalence exclusively, and more than half (53%) had data on either seroprevalence or genotypes. Almost half (47%) of the countries had no data on HHV-8 infection. There was high heterogeneity in the types of tests and interpretation algorithms used in determining HHV-8 seropositivity across the different studies. Generally, seroprevalence ranged from 2.0% in a group of young children in Eritrea to 100% in a small group of individuals with KS in Central African Republic, and in a larger group of individuals with KS in Morocco. Approximately 16% of studies reported on children. Difference in seroprevalence across the African regions was not significant (95% CI, χ2 = 0.86; p = 0.35), although specifically a relatively significant level of infection was observed in HIV-infected children. About 38% of the countries had data on K1 genotypes. K1 genotypes A, A5, B, C, F and Z occurred at frequencies of 5.3%, 26.3%, 42.1%, 18.4%, 5.3% and 2.6%, respectively. Twenty-three percent of the countries had data for K15 genotypes, and genotypes P, M and N occurred at frequencies of 52.2%, 39.1%, and 8.7%, respectively. Data on HHV-8 inter-genotype recombinants in Africa are scanty. HHV-8 may be endemic in the entire Africa continent but there is need for a harmonized testing protocol for a better understanding of HHV-8 seropositivity. K1 genotypes A5 and B, and K15 genotypes P and M, from Africa, should be considered in vaccine design efforts.

Genetic diversity and phylogeographic analysis of human herpesvirus type 8 (HHV-8) in two distant regions of Argentina: association with the genetic ancestry of the population

“…In addition, the African subtype B was detected in North-western Argentina which is consistent with the results obtained by ORF-26 subtype characterization. Moreover, we have reported for the first time the occurrence of the African subtypes A5 and F in Argentina, which had been previously described not only in Africa but also in France, Cuba and Brazil (Lacoste et al, 2000; Kourí et al, 2005; Kourí et al, 2012; Tozetto-Mendoza et al, 2016; Etta et al, 2018). These results highlight the African contribution to the demographic history of the country.…”

Seroprevalence and molecular diversity of Human Herpesvirus 8 among people living with HIV in Brazzaville, Congo

“…reports that subtype A was detected more frequently among HIV-infected patients with or without KS than HIV-negative subjects 15 . Previous studies have demonstrated the clustering patterns of HHV-8 subtypes with geography and ethnicity, and these may have arisen through ancient human migrations 44 , 47 . In addition, de Oliveira Lopes et al .…”

“…Among them, 6 samples were typable, and subtype A5 was the most predominant (50%), followed by B1 variant of subtype B (33%) and a subtype C variant close to C7 (17%). A5 and B subtypes are the most frequent subtypes found in sub-Saharan Africa, with a distribution on the African continent of 42%, 27% and 18% for subtypes B, A5 and C respectively 16 , 43 , 44 . Our results are consistent with Betsem et al .…”

Epidemiology and Genetic Variability of HHV-8/KSHV among Rural Populations and Kaposi’s Sarcoma Patients in Gabon, Central Africa. Review of the Geographical Distribution of HHV-8 K1 Genotypes in Africa

“…Although located in a highly endemic area, there is a lack of knowledge on the epidemiology of HHV-8 and KS in Gabon [ 50 , 51 ]. The present work aimed to gain new insights into the epidemiology of HHV-8 and its genetic diversity in this central African country.…”