Human herpesvirus 8 infection among adolescents in the REACH cohort

Objective: Human herpesvirus 8 (HHV-8) infection is common among children in areas where Kaposi sarcoma is endemic. Human herpesvirus 8 is uncommon in children but prevalent in adults at risk for human immunodeficiency virus (HIV) infection in the United States, including men who have sex with men (MSM) and women who engage in high-risk sexual behavior. We examined the prevalence and predictors of HHV-8 infection among adolescents with or at high risk for acquiring HIV infection. Design: Cross-sectional analysis. Setting: National study of HIV infection among adolescents in primary care. Participants: A total of 537 young adults practicing high-risk sexual behavior, of which 403 were women and 134 were men; among the 134 men, 75% were MSM. Interventions: Detailed questionnaires and testing for serum antibodies to HHV-8. Outcome Measure: Detection of serum antibodies to HHV-8. Results: Sixty (11.2%) of 537 young adults were HHV-8 seropositive, including 20 MSM (19.6%), 2 male heterosexuals (6.5%), and 27 female heterosexuals (8.2%). The prevalence of HHV-8 in HIV-positive MSM (17/74 [23.0%]) was twice as high as that in HIV-negative MSM (3/28 [10.7%]) (P=.18), but no characteristic predicted HHV-8 infection among MSM. In multivariate analysis, history of gonorrhea (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.4- 5.7; P <.01), history of having sex with women (OR, 2.4; 95% CI, 1.1-5.3; P=.03), and African American race (OR, 3.4; 95% CI, 1.1-10.0; P=.03) were associated with HHV-8 infection among women. Conclusions: Human herpesvirus 8 is common among US adolescents practicing high-risk sexual behaviors. Sexual identity, race, and sexual behavior may influence the risk of infection with HHV-8 in women.