High seroprevalence of human herpes virus 8 (HHV‐8) antibodies among vertically HIV‐infected pediatric patients living in Germany

Background Human herpes virus 8 (HHV‐8), a gamma herpes virus, is the etiological agent for Kaposi sarcoma (KS). HIV‐infected adults with advanced immunodeficiency are at risk. Prevalence data of HHV‐8 infection in HIV‐infected children living in non‐endemic areas are limited. Serologic studies indicate low seroprevalence rates of 3–4% for healthy children living in United States and Germany [1]. Purpose of the study The aim of the study was to determine the seroprevalence of HHV‐8 antibodies among vertically HIV‐infected pediatric patients in Germany and to evaluate their association with age, gender, ethnicity, and other demographic factors. Methods In 2012, a multi‐center cross‐sectional study was conducted in four University Hospitals in Germany. Stored frozen serum specimens obtained from vertically HIV‐infected children and adolescents were tested for antibodies against lytic and latent HHV‐8 antigens. Data on patients' demographic characteristics and medical history were recorded. Results A total of 214 HIV‐infected children and adolescents (105 males, 109 females) were included. The median age was 10.2 years (range 1 months–22.6 years). A high proportion of these children (62%) was born in Western Europe, whereas 65% (139/214) of their mothers were born in countries outside Western Europe. The majoritiy (91%) of the children had been treated with highly active antiretroviral therapy and 55.2% (116/210) had a HIV‐viral load<50 copies/mL. The median CD4 cell count was 1000/L (range 3–4400). The overall seroprevalence of HHV‐8 antibodies was 23.8% (51/214). Seroprevalence rates did not show significant differences between age or gender. In the group of young children aged 1 month to 35 months, 19.4% (46/31) had HHV‐8 antibodies, compared to 25% (25/100) in children aged 36 months to 11 years, and 24.1% (20/83) children 12 years and older. In the study group, seroprevalence rates were significantly lower in children who were born in Western Europe (p <0.01) compared to those born in Africa, Asia, or Eastern Europe. Clinical symptoms of HHV‐8 infection were reported to be uncommon; only one child had a history of KS at 2 years of age. Conclusions Vertically HIV‐infected pediatric patients living in Germany showed a high HHV‐8 seroprevalence of 23.8%. These rates were higher as expected in the normal pediatric population. The findings suggest that HHV‐8 infection occurred already in the first years of life.