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Sharing food, utensils associated with herpes virus 8 transmission in Zambia
Sharing of eating utensils within a household was associated with herpes virus 8 infection among children in Zambia, according to findings published in The Journal of Infectious Diseases.
“Human herpes virus 8 or Kaposi’s sarcoma-associated herpes virus, the eighth known human herpes virus, is known to be associated with the development of Kaposi sarcoma, primary effusion lymphoma and multicentric Castleman’s disease,” Janet Wojcicki, PhD, MPH, associate professor of pediatrics at the University of California, San Francisco, and colleagues wrote. “In sub-Saharan Africa and Mediterranean regions, [human herpes virus 8] infection is endemic; however risk factors for transmission are still not well-characterized although previous African studies have shown that [human herpes virus 8] infection may be associated with lower socioeconomic status and food-sharing behaviors. Several studies have shown that transmission of [human herpes virus 8] occurs within households in endemic populations, most likely via saliva exchange, although these studies have not delineated risk factors.”
Wojcicki and colleagues performed a prospective cohort study of 270 children, as well as the members of their households, in Lusaka, Zambia. All families had a child aged younger than 2 years at time of enrollment. The researchers recruited participants from August 2004 to April 2007 at a local clinic in Lusaka, and examined all family members at annual follow-up visits in addition to examining children every 4 months. A physician performed a through physical examination and tested participants for herpes virus 8 and HIV, also collecting new blood and saliva specimens at each visit. Families also received advice on HIV risk reduction during every visit. Follow-up was 4 years, and families filled out questionnaires regarding food-related behaviors.
One hundred thirty-seven children were infected over the course of the study (50.7%), the researchers reported.
The overall incidence of seroconversions was 30.07 per 100 child-years, the researchers wrote. Wojcicki and colleagues reported several independent risk factors for infection: a child sharing utensils with a primary caregiver (HR = 2.33; 95% CI, 1.49-7.14), having an increasing number of household members infected with herpes virus 8 (HR = 1.27; 95% CI, 1.09-2.79) and the presence of more than five siblings or children in the household (2.24; 95% CI, 1.03-4.88).
Increasing child age (HR = 0.96; 95% CI, 0.93-0.99) was protective against infection, Wojcicki and colleagues wrote, as was playing with at least five children a day (0.54; 95% CI, 0.33-0.89).
“Our study suggests specific routes for [human herpes virus 8] transmission in young children including sharing utensils and blowing on food prior to food sharing,” the researchers wrote. “In endemic areas of sub-Saharan Africa, including Zambia, where HIV is commonly associated with [herpes virus 8] and ART adherence is still a concern, it may be particularly important to counsel high-risk families with at-risk young infants and children.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.