Age- and Sex-Specific Seroprevalence of Human Herpesvirus 8 in Jamaica

A recent communication by Whitby et al. (1) in the Journal reported that the seroprevalence of human herpesvirus 8 (HHV-8) varies geographically in Italy, an area with an incidence of Kaposi's sarcoma ranging from 0.5 to 1.5 per 100 000 population. We evaluated the seroprevalence of HHV-8 in Jamaica, an area with a low incidence of Kaposi's sarcoma (2), and showed that the seroprevalence of HHV-8 among the population varied predominantly by age and sex. HHV-8 has been linked etiologically to classic and acquired immune deficiency syndrome-related Kaposi's sarcoma, primary effusion lymphomas, and multicentric Castleman's disease by serologic and molecular evaluations (3). Although Jamaica has a low incidence of Kaposi's sarcoma, several cases of multicentric Castleman's disease, a lymphoproliferative disorder, have been reported (4,5). We analyzed HHV-8 seroprevalence among two populations in Jamaica, 250 normal blood donors from the National Transfusion Service, Kingston, Jamaica, and 146 women visiting gynecology clinics affiliated with the University Hospital of the West Indies in Kingston. The median age among the blood donors was 41 years (range, 18–64 years), and 50% of them were female. The median age of the gynecology clinic patients was 33 years (range, 19–78 years). Sera were tested by use of whole virus (purified on a sucrose gradient) in an enzyme- linked immunoassay (Advanced Biotechnologies Inc. [ABI], Columbia, MD) and an immunofluorescence assay to detect lytic and latent proteins (ABI or Science Applications International Corp., Frederick, MD) (6). Serum samples were interpreted as seropositive if both immunoassays yielded positive results. Prevalence, expressed as percent seropositivity, of human herpesvirus 8 (HHV-8) in Jamaican blood donors—by age and sex. To yield a positive result, serum samples were required to test positive both to whole virus by use of an enzyme-linked immunoassay and to lytic and latent proteins of HHV-8 by use of an immunofluorescence assay. The overall seroprevalence among the blood donors tested was 3.6% (9/ 250). Among the normal blood donors, 5.0% of men (6/119) and 2.4% of women (3/122) had detectable levels of HHV-8 antibodies. Men were two times more likely to be seropositive than women (odds ratio 4 2.1; 95% confidence interval 4 0.43–12.9). Blood donors over the age of 40 years had a 2.9- fold greater likelihood of HHV-8 seropositivity (odds ratio 4 2.89; 95% confidence interval 4 0.53–29). The highest number of seropositives (6.9%) among both sexes was detected in individuals over the age of 50 years (Fig. 1). Among the women attending the gynecology clinics, only 0.68% (1/146) were seropositive, and that one seropositive patient was 44 years old. Thus, in the evaluation of HHV-8 seroepidemiology data among different subject populations, both age and sex of the individuals need to be considered.