AEGiS-14IAC: Estimated risk of human herpesvirus 8 transmission by blood transfusion, Uganda.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Estimated risk of human herpesvirus 8 transmission by blood transfusion, Uganda.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrC1374)

Hladik W, Dollard S, Downing R, Nzaro E, Kataaha P, Banage F, Ransom R, Karon J, Pellett P, Dondero T, Lackritz E, Mermin J
Centers for Disease Control and Prevention, Atlanta, United States

BACKGROUND: Kaposi's sarcoma, the most frequent malignancy in AIDS patients, is caused by human herpesvirus 8 (HHV8). It is unknown if HHV8 can be transmitted by blood transfusion; worldwide, blood donations are not screened for HHV8. We evaluated the risk of HHV8 transmission by transfusion in a hospital in Kampala, Uganda.

METHODS: We evaluated transfusion recipients and their linked blood donations, from December 2000-October 2001. Informed consent was given by recipients or their parents, and blood donors. We collected recipient blood samples prior to transfusion and one, two, and every four weeks thereafter for six months. Specimens were tested for HHV8 antibodies by two peptide-based enzyme immunoassays based on the ORF65 and K8.1 antigens, and by an immunofluorescence assay (IFA). Specimens reactive in any two assays or in the IFA were classified as HHV8-positive, all others as HHV8-negative. PCR and serological testing is ongoing. We compared HHV8 seroconversion in recipients of HHV8-positive and negative blood.

RESULTS: We evaluated 1811 patients who received 2687 blood units (72% packed cells, 19% whole blood) from 1795 blood donors. Recipients' median age was 1.8 years (range:0.1-89); 246 (14%) died. Median follow-up time was 150 days; 134 (7%) were lost to follow-up. At interim analysis, test results were available for a median of 29 days post-transfusion (interquartile range:28-32). Of 141 transfused units tested, 69 (49%) were HHV8-positive. Of 119 recipients, 42 (35%) tested HHV8-positive and 77 (65%) tested HHV8-negative prior to transfusion. Of the 63 HHV8-negative recipients with follow-up test results, HHV-8 seroconversion was similar among those who received HHV8-seropositive (2/31) and HHV8-seronegative transfusions (2/32, p=NS).

CONCLUSIONS: Blood donors and transfusion recipients in Uganda have high HHV8 seroprevalence. Interim analysis revealed no excess HHV8 seroconversion among recipients of HHV8-positive blood.

Keywords: AEGIS, Herpesvirus 8, Human, Blood Transfusion, Sarcoma, Kaposi, Blood Donors, Blood Banks, Seroepidemiologic Studies, Acquired Immunodeficiency Syndrome, Uganda, Polymerase Chain Reaction, Human, transmission, blood

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