Association Between Transfusion With Human Herpesvirus 8 Antibody-Positive Blood and Subsequent Mortality

• Published in: The Journal of infectious diseases 2012-11, Vol.206 (10), p.1497-1503
• Main Authors: Hladik, Wolfgang, Pellett, Philip E., Hancock, John, Downing, Robert, Gao, Hongjiang, Packel, Laura, Mimbe, Derrick, Nzaro, Esau, Mermin, Jonathan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antibodies; Antibodies, Viral - blood; Biological and medical sciences; Blood; Blood donation; Blood transfusion; Child; Child, Preschool; Cohort Studies; Death; Female; Fundamental and applied biological sciences. Psychology; Herpesviridae Infections - immunology; Herpesviridae Infections - mortality; Herpesviridae Infections - transmission; Herpesvirus 8, Human - immunology; HIV; HIV Infections - complications; Human herpesvirus 8; Human immunodeficiency virus; Humans; Infant; Infections; Infectious diseases; Malaria; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Mortality; Risk Factors; Transfusion Reaction; Uganda - epidemiology; Virology; VIRUSES; Young Adult
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jis543

Background. Human herpesvirus 8 (HHV-8) is endemic in Uganda and transmissible by blood. We evaluated mortality following transfusion of HHV-8 antibody-positive blood. Methods. In a hospital-based, observational, prospective cohort study with a 6-month follow-up, we examined the effect of HHV-8 antibody-positive blood on transfusion recipients surviving at least 7 days. Results. Of 1092 recipients, 471 (43.1%) were transfused with HHV-8 antibody-positive blood. Median age was 1.8 years (range, 0.1-78); 111 (10.2%) died during follow-up. After adjusting for confounders (increasing age, human immunodeficiency virus infection, illness other than malaria, receipt of multiple transfusions), recipients of HHV-8 antibody-positive blood stored ≤4 days ("short-stored") were more likely to die than recipients of HHV-8 antibody-negative blood (adjusted hazards ratio [AHR], 1.92; 95% confidence interval [CI], 1.21-3.05; P = .01). The AHR of the effect of each additional short-stored HHV-8 antibody-positive transfusion was 1.79 (95% CI, 1.33-2.41; P = .001). Conclusions. Transfusion with short-stored HHV-8 antibody-positive blood was associated with an increased risk of death. Further research is warranted to determine if a causal pathway exists and to verify the observed association between acute HHV-8 infection and premature mortality.