Human herpesvirus 8 (HHV-8) salivary shedding in mothers and children from Uganda: risk factors and clues about transmission

Abstract

Background: in Africa, the increase of Kaposi Sarcoma-associated herpesvirus (KSHV/HHV-8) seroprevalence during childhood suggests an horizontal intrafamilial transmission. However, the exact transmission modes are yet unknown, but there is evidence that the virus is intermittently spread through the saliva of seropositive subjects. Furthermore, a significant correlation was found between the geographical distribution of bloodsucking arthropods and incidence rates of Kaposi Sarcoma. In this view, key roles can be played by: i) the inflammatory reaction due to the arthropod bites which create a micro-environment favourable to viral replication, and ii) the use of saliva as firstaid medication in several circumstances. According to that, the viral transmission could occur through the application of mothers' saliva on children's skin to relieve itching and scratching after a bloodsucking arthropod bite. This work investigated the risk factors involved in HHV-8 transmission based on the "promoter arthropod hypothesis". Methods: one hundred and thirty questionnaires were administered to Ugandan children (54 from settled and 76 from nomad communities) to evaluate the skin inflammatory reaction to the arthropod bites and the frequency of behavioural practices associated with saliva usage. At the same time saliva samples were collected from the children and respective mothers to detect the presence of HHV-8 DNA by Real-Time PCR. Results: we detected HHV-8 DNA in 23.85% of mothers and in 11.54% of children. The use of saliva is significantly more common in settled than in the nomad communities (p<0.001). The statistical analysis showed significant association between: i) skin inflammatory reaction and use of saliva in both groups; ii) environmental factors which increase the presence of bloodsucking arthropods and skin inflammatory reaction. Discussion: from our data we suppose that HHV-8 transmission could occur through non-sexual routes and that the infected saliva applied at child bite site could represent a favourable condition for the acquiring of the infection.

Absence of the human CYP2C8*3 allele in Ugandan children exposed to Plasmodium falciparum malaria

“…We enrolled 262 children (mean age 7.8 ± 3.0) that we selected as unrelated according to family names and interviews with parents/carers. Signed informed consent for multiple genetic and epidemiologic surveys was obtained from the children's parents/carers (Romano et al, 2010(Romano et al, , 2011. This study was conducted with the approval of the ethics committee and research committee of the ''Sapienza'' University of Rome.…”

Distribution of human CYP2C8*2 allele in three different African populations

“…For the purpose of the study were considered only unrelated individuals according to different family names and interviews. The same protocol for enrollment was followed in all sites [ 25 , 26 ]. Signed informed consent for multiple genetic and epidemiologic surveys was obtained from the subjects or their parents/caregivers [ 25 , 26 ].…”

“…The same protocol for enrollment was followed in all sites [ 25 , 26 ]. Signed informed consent for multiple genetic and epidemiologic surveys was obtained from the subjects or their parents/caregivers [ 25 , 26 ]. This study was conducted with the approval of the ethics committee and research committee of the Sapienza University of Rome.…”