Seroprevalence of Human Herpesvirus 8 and Selected Associated Factors Among Blood Donors at Two Blood Donor Centres in Nairobi, Kenya.

Abstract

Background: Human Herpesvirus 8 (HHV8), also known as Kaposi sarcoma associated herpes virus (KSHV) has been isolated as the causative virus for all types of Kaposi sarcoma (KS); endemic, classic, epidemic and transplant associated KS, primary effusion lymphoma and multicentric Castleman disease. Several studies have reported significant risk of HHV 8 transmission through blood transfusions in endemic regions that include Sub-Saharan Africa. HHV 8 seroprevalence among healthy blood donors has been documented in several countries. In Kenya the seroprevalence of HHV 8 and its associated factors among healthy blood donors has not been investigated. Objectives: To determine the seroprevalence of Human Herpesvirus 8 and its associated factors among healthy blood donors in Blood Transfusion Unit (BTU) -Kenyatta National Hospital (KNH) and the Regional Blood Transfusion Centre (RBTC), Nairobi. Study design: Cross-sectional descriptive study. Study site: The Regional Blood Transfusion Centre, Nairobi, Blood Transfusion Unit, KNH and University of Nairobi Institute of Tropical and Infectious Diseases (UNITID) laboratory. Materials and methods: A total of one hundred and sixty-five blood donors who met the preset national guidelines for blood donation at the two donor centers were consecutively recruited into the study. A questionnaire was administered and socio-demographic data (age, gender, marital status, level of education and socio-economic status) recorded. Blood samples were drawn for routine tests and HHV 8 serology which was carried out using HHV 8 immunoglobulin G antibody enzyme linked immunosorbent assay (ELISA) technique. The results of routinely screened transfusion transmitted infections (HIV, hepatitis B and C and syphilis) were obtained from the donor registers at the BTU, KNH and the RBTC. Data management: Socio-demographic data and laboratory results were entered into predesigned study questionnaires. This data was then entered and analyzed with the use of Statistical Package for Social Sciences (SPSS) version 21. Demographic data that was categorical was summarized and presented as frequencies and proportions. Pearson Chi-Square test and Fisher’s Exact tests were used to test association between demographic and laboratory findings xv Results: A total of one hundred and sixty-five blood donors were recruited into the study. The socio-demographic data revealed that 127 (77.0%) of the donors were male while 38 (23.0%) were female. Majority of them had attained tertiary level of education (118 [71.5%]), followed by secondary level (34 [20.6%]), and 13 (7.9%) having attained the primary level of education. The marital status of the donors revealed that 90 (54.2%) were single, while 76 (45.8%) were married. The findings also showed that majority of the participants were voluntary donor type (116 [70.3%]), while the rest were replacement (49 [29.7%]). The HHV 8 seroprevalence was found to be 43.6% and there were no statistically significant associations observed between HHV 8 seroprevalence and socio-demographic data that included age, sex, marital status, level of education and socioeconomic status. Similarly, routinely screened transfusion transmitted infections (TTIs) i.e. HIV, Hepatitis B and C and syphilis did not reveal any influence on HHV 8 status. Conclusions: HHV 8 seroprevalence among health blood donors at BTU, KNH and RBTC, Nairobi is high (43.6%). There were no significant associations determined between HHV 8 seroprevalence and the factors assessed that included sociodemographic data (age, sex, marital status, level of education and socioeconomic status) and no correlation was found between HHV 8 seropositivity and routinely screened TTIs (HIV, Hepatitis B and C viruses and syphilis) Recommendations: A larger study and a different study design are required to define any associated risk factors associated with the high HHV 8 seroprevalence in our setting such as routinely screened TTIs since the number of blood donors that were positive for these TTIs was low in this study. Further studies are needed to better quantify the absolute risk of acquiring HHV 8 infection from blood transfusion and determine the need for screening of blood units for HHV-8 in high endemic areas especially when blood is to be transfused to immunocompromised individuals.