KSHV Infection Among Children in subSaharan Africa

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KSHV Infection Among Children in sub-Saharan
Africa
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Background

• It is known that KSHV infection in Africa most
  commonly occurs in childhood, and that saliva is
  the body fluid that most commonly harbors KSHV.
• However little is known about demographic (e.g.
  geographic), behavioral (e.g., exposures to other
  children and adults), or biological (e.g.,
  concurrent HIV infection) determinants of KSHV
  infection among children.
• There is also limited information about clinical
  manifestations of primary KSHV infection.

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Aims

• To compare the prevalence of KSHV in Ugandan
  children lt 10 years old to South African children
  lt 10 years old.
• To compare the prevalence of KSHV in HIV-infected
  and HIV-uninfected Ugandan children.
• To evaluate KSHV incidence and determinants of
  incident KSHV infection among Ugandan children.
• To describe clinical and laboratory
  manifestations of primary KSHV infection in
  Ugandan children and to determine whether
  concurrent HIV infection modifies these
  manifestations.

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Study population

• We will include children lt 10 years old enrolled
  in
• The South Africa KSHV study
• Cross-sectional study in which door-to-door
  sampling of saliva of 427 children ages 2, 4, and
  8 years residing in an urban settlement in Durban
  was done.
• HIV-uninfected children enrolled in the U01
  study
• HIV-infected children enrolled in the CHAMP
  study.

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Methods

• 40?l of serum stored routinely for CHAMP and UO1
  will be used.
• KSHV antibody analysis will be done at CDC,
  Atlanta.
• Baseline seroprevalence survey will be done.
• Any patient negative at baseline will have
  repeated antibody testing done until the time of
  seroconversion

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Measurements

• Aim 1
• Cross-sectional study design
• Outcome KSHV antibody status in Ugandan children
  vs. S.African children.
• Aim 2
• Cross-sectional study design
• Outcome KSHV antibody status in HIV-infected vs.
  uninfected children

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Measurements

• Aim 3
• Prospective cohort study design
• Outcome KSHV antibody seroconversion.
• Aim 4
• Nested case-control approach (14 matching)
• Outcome Clinical outcomes fever, rash,
  lymphadenopathy, and other signs and symptoms
  collected by parent cohorts. Laboratory
  outcomes plasma and white blood cell-associated
  KSHV DNA.

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Next steps

• Lisa to complete analyses and write manuscript
  draft for Aim 1 results.
• Generate list of patient IDs
• Preparation of serum samples for shipment
• Preparation of MTA to facilitate specimen
  transfer
• Preparation of participant datasets