N Engl J Med. 2006 Sep 28;355(13):1331-8. Links
Comment in:
N Engl J Med. 2006 Sep 28;355(13):1303-5.
N Engl J Med. 2007 Jan 4;356(1):87; author reply 89.
Transmission of human herpesvirus 8 by blood transfusion.
* Hladik W,
* Dollard SC,
* Mermin J,
* Fowlkes AL,
* Downing R,
* Amin MM,
* Banage F,
* Nzaro E,
* Kataaha P,
* Dondero TJ,
* Pellett PE,
* Lackritz EM.
Global Acquired Immunodeficiency Syndrome Program, National Center for Human Immunodeficiency Virus, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Entebbe, Uganda.
BACKGROUND: Whether human herpesvirus 8 (HHV-8) is transmissible by blood transfusion remains undetermined. We evaluated the risk of HHV-8 transmission by blood transfusion in Uganda, where HHV-8 is endemic. METHODS: We enrolled patients in Kampala, Uganda, who had received blood transfusions between December 2000 and October 2001. Pretransfusion and multiple post-transfusion blood specimens from up to nine visits over a 6-month period were tested for HHV-8 antibody. We calculated the excess risk of seroconversion over time among recipients of HHV-8-seropositive blood as compared with recipients of seronegative blood. RESULTS: Of the 1811 transfusion recipients enrolled, 991 were HHV-8-seronegative before transfusion and completed the requisite follow-up, 43% of whom received HHV-8-seropositive blood and 57% of whom received seronegative blood. HHV-8 seroconversion occurred in 41 of the 991 recipients. The risk of seroconversion was significantly higher among recipients of HHV-8-seropositive blood than among recipients of seronegative blood (excess risk, 2.8%; P<0.05), and the increase in risk was seen mainly among patients in whom seroconversion occurred 3 to 10 weeks after transfusion (excess risk, 2.7%; P=0.005), a result consistent with the transmission of the virus by transfusion. Blood units stored for up to 4 days were more often associated with seroconversion than those stored for more than 4 days (excess risk, 4.2%; P<0.05). CONCLUSIONS: This study provides strong evidence that HHV-8 is transmitted by blood transfusion. The risk may be diminished as the period of blood storage increases. Copyright 2006 Massachusetts Medical Society.