869 
Kaposi’s Sarcoma Herpes Virus Is Not Associated with Sexually Transmitted Infections or High-risk Sexual Behavior in a South African Heterosexual Population
Babatyi Innocentia Malope*1,2, Babatyi Innocentia Malope*1,2, P MacPhail1, G Mbisa3, C MacPhail3, L Stein2, E Ratshikhopha2, L Ndhlovu4, C Searle4, F Sitas5, and D Whitby3
1Univ of the Witwatersrand, Johannesburg, South Africa; 2Natl Hlth Lab Svc, Johannesburg, South Africa; 3NCI-Frederick, MD, US; 4Population Council, Johannesburg, South Africa; and 5Cancer Council, New South Wales, Sydney, Australia
Background: Kaposi’s Sarcoma
Herpes Virus (KSHV) transmission patterns
in Africa, where KSHV infection and HIV are common, are difficult to characterize.
Subjects: As
part of the Mothusimpilo community survey in Carletonville,
South Africa, we
studied 2103 black participants (862 miners, 95 sex workers, 731 female, and 415
male township residents). The mean age of all subjects was 33.2 (±10.1). Male
residents were significantly younger and miners older than sex workers and female
residents (p <0.0001).
Methods: Sera were tested for lytic K8.1 and latent
Orf73 KSHV, HIV, Gonococcus, HSV-2, syphilis,
and Chlamydia antibodies. Subjects
positive for lytic or latent KSHV antibodies were classified as seropositive.
Odds ratios were adjusted for age and sex and expressed as OR (95%CI).
Results: Overall
HIV prevalence was 40% and was highest in sex workers, female residents, miners,
and male residents (77%, 48%, 37%, and 22%). Risk for HIV infection was 12-, 3-,
and 2-fold higher in sex workers, female residents, and miners—11.6 (6.8 to 19.8),
3.2 (2.4 to 4.4), 2.0 (1.5 to 2.7); p
<0.001—compared with male residents. Of the total, 66% were seropositive for HSV-2 infection; lower prevalence was found
for Gonococcus (6%), Chlamydia (8%), and syphilis (8%).
Increased risks for gonococcal infection and Chlamydia—2.0 (1.2–3.5) and 2.0 (1.2 to 3.1)—were
only noted in female residents. Female residents and sex workers were at an
increased risk for syphilis—1.9 (1.2 to 3.0), 2.4 (1.2 to 4.8)—and HSV-2—2.6
(2.0 to 3.6) and 12.6 (4.5 to 35.6)—vs male
residents. HHV-8 prevalence was 48%. Unlike HIV infection and the other
sexually transmitted infections (STI), no significant differences in HHV-8
status were noted among the residential groups, with no evident risk for
increased HHV-8 infection in any of these diverse community groups compared to
male residents —1.1 (0.85 to 1.4), 1.1 (0.8 to 1.3), and 1.2 (0.8 to 1.8).
Conclusions: The pattern of HIV and STI infection in sex workers
clearly marks sexual behavior as an increased risk in these groups. A similar
pattern for KSHV was not apparent, even in sex-workers, suggesting that KSHV is
not sexually transmitted in this heterosexual South African population.
|
