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. 2025 May;65(5):827-833.
doi: 10.1111/trf.18236. Epub 2025 Apr 2.

Kaposi's sarcoma herpesvirus seroprevalence among blood donors in Uganda

Tait Huso  1 , Jodie L White  1 , Dorothy Kyeyune  2 , Angela D'Adamo  1 , Nazzarena Labo  3 , Wendell Miley  3 , Ezra Musisi  2 , Khan Moses  2 , Ronnie Kasirye  4 , Irene Lubega  4 , Hellen Wambongo Musana  4 , Priscilla Eroju  4 , Mahnaz Motevalli  1 , Raymond Goodrich  5 , M Kate Grabowski  1 , Thomas C Quinn  6 , Paul M Ness  1 , Heather A Hume  7 , Henry Ddungu  8 , Aggrey Dhabangi  9 , Evan M Bloch  1 , Mary Glenn Fowler  1 , Philippa Musoke  4 , Denise Whitby  3 , Aaron A R Tobian  1
Affiliations

Kaposi's sarcoma herpesvirus seroprevalence among blood donors in Uganda

Tait Huso et al. Transfusion. 2025 May.

Abstract

Background: Kaposi's sarcoma herpesvirus (KSHV) causes a life-long infection that can progress to several types of KSHV-associated diseases. There is evidence for transfusion transmission of KSHV. In endemic regions, such as sub-Saharan African, KSHV seroprevalence is >40%. However, previous studies of blood donors utilized immunoassays that detect KSHV-associated disease-specific antigens, which may underestimate the true burden of KSHV in a healthy population.

Study design and methods: We utilized samples from an on-going transfusion transmitted infection clinical trial to estimate the seroprevalence of KSHV among 4921 blood donations from healthy donors in Uganda collected between October 2019 and December 2022. A multiplexed bead-based assay was used to measure plasma IgG against five antigens encoded by the K8.1, K10.5, ORF73, ORF38, and ORF25 genes of KSHV. Significant associations between donor characteristics and seroprevalence were assessed by chi-square tests.

Results: Overall, KSHV seroprevalence was 69.1%. Seroprevalence was higher in units collected from older donors compared with younger donors and male donors (71.9% [95% confidence interval (CI) = 70.4%-73.3%]) compared with female donors (61.3% [95% CI = 58.6%-64.0%]; p < .001). KSHV seroprevalnce was higher among units collected from donors positive for T. pallidum (82.5% [95% CI = 73.8%-89.3%]) compared with units collected from donors who were negative (68.8% [95% CI = 67.5%-70.1%]; p < .001). KSHV seroprevalence was higher in units that tested positive for HIV, HBV, or HCV, though these results were not statistically significant.

Conclusion: Given the high seroprevalence and limited availability of lab assays that detect active KSHV infections, methods such as leukoreduction or pathogen reduction should be considered to potentially reduce the risk of transfusion transmission of KSHV.

Keywords: Uganda; donor screening; human herpesvirus 8; transfusion transmission.

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Conflict of interest statement

DISCLOSURE OF CONFLICTS OF INTEREST

All authors are either are co-investigators or principal investigators on a clinical trial funded by the US Department of Defense assessing the efficacy of Mirasol whole blood pathogen reduction. AART reports personal fees from Ortho Clinical Diagnostics, Grifols, and Theraflex, outside of the submitted work. EMB reports personal fees and non-financial support from UptoDate, Tegus and Health Advances outside of the submitted work. EMB is a member of the United States Food and Drug Administration (FDA) Blood Products Advisory Committee. Any views or opinions that are expressed in this manuscript are those of the author’s, based on his own scientific expertise and professional judgment; they do not necessarily represent the views of either the Blood Products Advisory Committee or the formal position of FDA, and do not bind or otherwise obligate or commit either Advisory Committee or the Agency to the views expressed.

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