Human herpes virus-8 (HHV-8) or Kaposi's sarcoma associated herpes virus is the etiologic agent of Kaposi's Sarcoma (KS), a hallmark for AIDS patients. Even in the era of antiviral therapy (ARV), KS is still very common in sub-Saharan Africa, where ARV is still not widely available. In countries like Zambia, KS is one of the most prevalent pediatric tumors. Our laboratory has previously demonstrated that children in Zambia acquire HHV-8 infection in early childhood and saliva is the likely source of infection, however, there is a paucity of information regarding the epidemiology and risk factors for transmission. To gain further '.understanding of HHV-8 in this high-risk area, we have enrolled households, with at least one child uninfected at the time of enrollment, and then following them for HHV-8 infection. The overall objective is to describe the route of transmission of HHV-8 and whether transmission occurs within a household to a susceptible child. We have now enrolled 682 households in Zambia and my study has three specific aims. The first is to determine risk factors associating with HHV-8 positive households as compared to negative households;these factors include geographical distribution, social and behavioral factors such as feeding habits. This was carried out the collection of information through extensive questionnaires during the enrollment of the family.
The second aim i s to follow the child for sero-conversion at follow-up. This will be carried out by following the uninfected child every four months to determine those who were infected since last follow-up. The third specific aim is to determine the risk factors associated with the household and the .child during seroconversion. We will focus on whether HHV-8 can be transmitted through casual contact and household behaviors that increase salivary exposure. For this study we will be using immuno-fluoresence 'assays to determine the HHV-8 serostatus of uninfected index children and their household members. We will be assessing salivary contact of household behaviors that increase salivary exposure through extensive questionnaires, and completing statistical analysis to look for significance. We will be taking into account socio-economic and general health status of the entire households enrolled in our study. This study is significant as this will determine the possible routes of HHV-8 whether it is from within families and the risk factors associated with it. This information should lead to the development of strategies to facilitate behavioral changes to help decrease the incidence of infection in children and the development of KS.