Correlates of human herpesvirus 8 seropositivity among heterosexual men in Kenya

Abstract

Background: Several studies have suggested that sexual transmission of human herpesvirus 8 (HHV-8) occurs among homosexual men in developed countries. However, few studies have examined heterosexual HHV-8 transmission, especially among African populations in which HHV-8 is endemic. Objectives: To determine the seroprevalence and correlates of HHV-8 infection among heterosexual African men. Design: Cross-sectional study. Methods: Participants were 1061 men enrolled in a prospective cohort study of risk factors for HIV-1 acquisition among trucking company employees in Mombasa, Kenya. Stored frozen sera from the study baseline visit were tested for antibodies to HHV-8 by whole-virus lysate ELISA. Results: HHV-8 seroprevalence was 43%. In multivariate logistic regression analysis, HHV-8 infection was independently associated with older age [for men aged 30–39 years: odds ratio (OR), 1.5; 95% confidence interval (CI), 1.1–2.0; for men aged > 40 years: OR, 1.7; 95% CI, 1.1–2.7, compared with men aged , 30 years], Christian religion (OR, 1.6; 95% CI, 1.2–2.1), being uncircumcised (OR, 1.5; 95% CI, 1.0–2.2), and ever having syphilis (OR, 2.2; 95% CI, 1.4–3.5). Ever having used condoms was associated with decreased likelihood of infection (OR, 0.7; 95% CI, 0.6–1.0). Seropositivity was not significantly related to other sexual behaviors characterized or to HIV-1 status. Conclusions: HHV-8 seropositivity is common in this population and increases with age, suggesting on-going transmission during adulthood. Infection was more common among men who were uncircumcised or who had ever had syphilis and was less common among those who had ever used condoms, suggesting that sexual factors may play a role in HHV-8 transmission. Prospective studies of HHV-8 acquisition in heterosexual African populations are needed to demonstrate whether safer sexual practices can reduce transmission.