811 Bloodborne Transmission of Kaposi's Sarcoma-associated Herpesvirus (Human Herpesvirus 8) in Children with Sickle Cell Disease S. Mbulaiteye*1, R. J. Biggar1, C. Ndugwa2, P. Bakaki2, R. Pfeiffer1, D. Whitby1, E. A. Engels1 1Natl Cancer Inst, Rockville, MD and 2Makerere Univ, Kampala, Uganda
Background: Routes of transmission for Kaposi's sarcoma-associated herpes virus (KSHV), the causative agent of KS, are not well understood. KSHV can be detected in peripheral blood, but transmission through blood transfusion has not previously been previously reported. We examined the risk for transfusion-acquired KSHV in a cross-sectional study of children with sickle cell anemia in Uganda.
Methods: We enrolled 609 children with sickle cell anemia aged 1-15 yrs from the Sickle Cell Clinic at Mulago Hospital in Kampala. Interviewers elicited transfusion history and obtained blood obtained for KSHV testing. KSHV status was evaluated using an enzyme immunoassay for antibodies against the KSHV K8.1 glycoprotein.
Results: Overall KSHV seroprevalence was 22.1%. Transfused children had higher seroprevalence than those never transfused (25.1 vs 17.9%, p = 0.04). Seroprevalence increased with number of transfusions: seroprevalence was 17.9%, 19.5%, 22.5%, 29.5%, and 34.6% among children with 0, 1, 2, 3, or 4+ transfusions, respectively. Seroprevalence also increased with age (p for trend < 0.001): seroprevalence was 7.5%, 14.1%, 15.7%, 30.8%, 32.1%, and 33.3% among children aged 0-3, 4-5, 6-7,8-9, 10-12, and 13 yrs or older, respectively. After adjusting for age, transfused children still had higher KSHV seroprevalence compared with untransfused children: adjusted odds ratios (95% CIs) were 1.05 (0.60-1.86), 1.14 (0.60-2.16), 1.80 (0.84-3.83), and 2.23 (1.23-4.03) for children with 1, 2, 3, or 4+ transfusions, respectively.
Conclusions: While the KSHV prevalence rose with age, as expected, we observed an independent association with prior transfusion in children with sickle cell anemia in Uganda. Our study indicates that KSHV may be transmitted by blood transfusions.