Human herpesvirus 8 transfusion transmission in Ghana, an endemic region of West Africa

Abstract

BACKGROUND: Human herpesvirus 8 (HHV‐8) seroprevalence ranges between less than 5% in Europe and North America and 50% to 70% in sub‐Saharan Africa. Evidence of HHV‐8 transfusion transmission is only indirect. We conducted a serologic (anti‐HHV‐8) and molecular (HHV‐8 DNA) study of samples from paired donor‐immunocompetent recipients transfused with whole blood. STUDY DESIGN AND METHODS: Samples from 252 donor‐recipient pairs were tested. Immunoglobulin G to HHV‐8 was detected with enzyme immunoassays and confirmed with an in‐house immunofluorescence assay. The cellular fraction from seroreactive donors and their recipients was tested for HHV‐8 DNA. RESULTS: Anti‐HHV‐8 was positive (reactive in two or more assays) in 28 (11%) patients and 16 (6%) donors. Of 12 seronegative recipients (at risk of transmission) receiving seropositive blood, one very likely transmission was identified (8.3% confidence interval, 0%‐23%). The donor blood contained HHV‐8 DNA and his and four other donors' sequences clustered separately from recorded genotypes with a 97% bootstrap constituting a distinct genotype. CONCLUSIONS: HHV‐8 is transmitted in Ghana but does not carry clinical consequences since most patients are immunocompetent. The clinical risk will increase with the availability of immunosuppressive drugs in sub‐Saharan Africa. We propose that a new genotype (HHV‐8‐G for Ghana) be added to the current nomenclature.

Fourteen‐year experience of a tertiary hospital transfusion committee in West Africa

“…Emerging or known but untested infectious agents were explored to determine the prevalence and potential feasibility and efficacy of screening. This was the case for GB virus‐C, West Nile virus, parvovirus B19, and human herpesvirus 8 24‐27. Syphilis was not tested for until a study was conducted and showed one case of likely transmission .…”

Blood transfusion safety in sub‐Saharan Africa: A literature review of changes and challenges in the 21st century

“…60 However, a 2012 Ghanaian study documented seroconversion in a previously seronegative patient following transfusion of HHV8 contaminated WB. 61…”

Pathogen reduction of whole blood: utility and feasibility

“…However, a few other transfusion‐transmitted infectious agents that are presently not screened but are relatively frequent in sub‐Saharan Africa (SSA) could also be monitored to further demonstrate the in vitro–in vivo correlation of efficacy. Bacterial contamination known to range between 3 and 20% in SSA (Adjei et al, ; Hassall et al, ; Opoku‐Okrah et al, ; Makuni et al, ), and HHV‐8, an intracellular virus present in approximately >20% of SSA blood donors, would be suitable targets (Gobbini et al, ; Hladik et al, ). Efficacy regarding serologically screened viruses, such as HIV‐1/2, HBV or HCV, could not be tested considering the very low prevalence of missed infections.…”