Socio-Economic and Other Correlates of Kaposi
Sarcoma-Associated Herpesvirus Seroprevalence
Among Older Adults in Sicily
Colleen Pelser,1,2 Francesco Vitale,3 Denise Whitby,4 Barry I. Graubard,1 Angelo Messina,5
Lorenzo Gafa` ,6 Elizabeth E. Brown,7 Lesley A. Anderson,1,8 Nino Romano,3
Carmela Lauria,6 and James J. Goedert1*
1Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health,
Rockville, Maryland
The virus that causes Kaposi sarcoma, KSassociated herpesvirus (KSHV, also known
as human herpesvirus 8) has an unusual distribution and poorly characterized modes of
transmission. To clarify these issues, sociodemographic correlates of KSHV seroprevalence
were examined in a population-based study.
In 1,154 randomly sampled adults (aged 32–92, mean 71 years) throughout Sicily, KSHV
antibodies were detected with four assays and a conservative algorithm. Seroprevalence was
re-weighted to the population. Odds ratios with 95% confidence intervals (OR, CI) from
multivariate logistic regression were used to estimate associations of seroprevalence with
interview data. KSHV seroprevalence was 8.5%, including 5.3% among men (N¼848)
and 11.5% among women (N¼306, P¼0.22).
Seroprevalence was higher with residence in a smaller community during childhood (Ptrend¼
0.03) and working with plants/soil during adulthood (OR 2.9, CI 1.1–7.9); these were
especially strong among women. Among men, seroprevalence was significantly associated
with lower education (OR 2.6, CI 1.1–5.9) and migration to a larger community (OR 0.3,
CI 0.1–0.9). Other demographic and household variables were unrelated to seroprevalence.
From these data, KSHV in Sicily appears to be related to low socio-economic status, but
micro-endemicity in small communities cannot be excluded. J. Med. Virol. 81:1938–1944,
2009. _ 2009 Wiley-Liss, Inc.{
KEY WORDS: herpesviridae; Kaposi sarcoma; Italy; socio-economic status;migration