Human herpesvirus 8 transfusion transmission in Ghana, an endemic region of West Africa

Abstract

Human herpesvirus 8 (HHV-8) seroprevalence ranges between less than 5% in Europe and North America and 50% to 70% in sub-Saharan Africa. Evidence of HHV-8 transfusion transmission is only indirect. We conducted a serologic (anti-HHV-8) and molecular (HHV-8 DNA) study of samples from paired donor-immunocompetent recipients transfused with whole blood. Samples from 252 donor-recipient pairs were tested. Immunoglobulin G to HHV-8 was detected with enzyme immunoassays and confirmed with an in-house immunofluorescence assay. The cellular fraction from seroreactive donors and their recipients was tested for HHV-8 DNA. Anti-HHV-8 was positive (reactive in two or more assays) in 28 (11%) patients and 16 (6%) donors. Of 12 seronegative recipients (at risk of transmission) receiving seropositive blood, one very likely transmission was identified (8.3% confidence interval, 0%-23%). The donor blood contained HHV-8 DNA and his and four other donors' sequences clustered separately from recorded genotypes with a 97% bootstrap constituting a distinct genotype. HHV-8 is transmitted in Ghana but does not carry clinical consequences since most patients are immunocompetent. The clinical risk will increase with the availability of immunosuppressive drugs in sub-Saharan Africa. We propose that a new genotype (HHV-8-G for Ghana) be added to the current nomenclature.