Lack of evidence for frequent heterosexual transmission of human herpesvirus 8 in Zimbabwe

Abstract

Background: There is conflicting evidence about the contribution of heterosexual transmission to the spread of human herpesvirus 8 (HHV-8) in southern Africa. This study evaluated the hypothesis that HHV-8 infection is associated with risk factors for human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections among Zimbabwean men.

Methods: HHV-8 seroprevalence was determined for 2750 participants in the Zimbabwe AIDS Prevention Project cohort of male factory workers in Harare, Zimbabwe. Potential associations of HHV-8 antibody detection with risk factors for HIV-1 infection were examined by univariate analysis. Variables with P < .1 in the univariate analysis were included in a multivariate logistic regression model. HHV-8 seroprevalence was also determined among 297 heterosexual couples.

Results: Prevalence of HHV-8, HIV-1, and HHV-8 and HIV-1 coinfection was 28.5% (95% confidence interval [CI], 26.8%-30.2%), 19.5% (95% CI, 18.0%-20.9%), and 6.5% (95% CI, 5.6%-7.5%), respectively. Detection of HHV-8 antibodies was independently associated with older age and HIV-1 infection but not with number of recent sex partners, marital status, education, condom use, prior sexually transmitted infections, payment for sex, chronic hepatitis B infection, or incident HIV-1 infection. HHV-8 seroprevalence was 31.7% (95% CI, 26.3-37.0) among wives in the couples tested, but HHV-8 infection of wives was not associated with HHV-8 infection of husbands (odds ratio, 1.08; 95% CI, 0.62-1.88; P = .8).

Conclusions: HHV-8 and HIV-1 infection did not have common sexual risk factors among urban Zimbabwean men. Sexual transmission does not explain the high prevalence of HHV-8 in this population.

Figure 1

Multivariate analysis of factors associated with human immunodeficiency virus type 1 (HIV-1; A) and human herpesvirus 8 (HHV-8; B) prevalence among male Zimbabwean factory workers. Only variables with P ≤ .1 in the univariate analyses were included in the multivariate models. Horizontal bars indicate the 95% confidence intervals for the multivariate odds ratio for each variable. HBV, hepatitis B virus; STI, sexually transmitted infection.

Figure 2

Relationship of human immunodeficiency virus type 1 (HIV-1) and human herpesvirus 8 (HHV-8) prevalence to age of male Zimbabwean factory workers. The prevalence of HIV-1 (solid circles), HHV-8 (open circles), and coinfection with both HIV-1 and HHV-8 (solid triangles) is shown for each age decatile. The number of subjects in each age group (N) is shown. Error bars represent the 95% confidence interval for the prevalence estimate in each age group.

Figure 3

Relationship of human immunodeficiency virus type 1 (HIV-1) and human herpesvirus 8 (HHV-8) serostatus in heterosexual Zimbabwean couples. Male participants were grouped according to baseline HIV-1 and HHV-8 antibody detection results. Bars show the seroprevalence of HIV-1 and HHV-8 among the female sex partners of the men in each group. The number of sex partners in each group (N) is shown. Error bars represent the 95% confidence intervals for seroprevalence among the female partners.