Human herpesvirus 8 transfusion transmission in Ghana, an endemic region of West Africa

BACKGROUND: Human herpesvirus 8 (HHV‐8) seroprevalence ranges between less than 5% in Europe and North America and 50% to 70% in sub‐Saharan Africa. Evidence of HHV‐8 transfusion transmission is only indirect. We conducted a serologic (anti‐HHV‐8) and molecular (HHV‐8 DNA) study of samples from paired donor‐immunocompetent recipients transfused with whole blood. STUDY DESIGN AND METHODS: Samples from 252 donor‐recipient pairs were tested. Immunoglobulin G to HHV‐8 was detected with enzyme immunoassays and confirmed with an in‐house immunofluorescence assay. The cellular fraction from seroreactive donors and their recipients was tested for HHV‐8 DNA. RESULTS: Anti‐HHV‐8 was positive (reactive in two or more assays) in 28 (11%) patients and 16 (6%) donors. Of 12 seronegative recipients (at risk of transmission) receiving seropositive blood, one very likely transmission was identified (8.3% confidence interval, 0%‐23%). The donor blood contained HHV‐8 DNA and his and four other donors' sequences clustered separately from recorded genotypes with a 97% bootstrap constituting a distinct genotype. CONCLUSIONS: HHV‐8 is transmitted in Ghana but does not carry clinical consequences since most patients are immunocompetent. The clinical risk will increase with the availability of immunosuppressive drugs in sub‐Saharan Africa. We propose that a new genotype (HHV‐8‐G for Ghana) be added to the current nomenclature.