© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 3, 194-202,
February 7, 2001
© 2001 Oxford University Press
Seroepidemiology and Molecular Epidemiology of Kaposi's Sarcoma-Associated Herpesvirus Among Jewish Population Groups in Israel
Affiliations of authors: B. Davidovici, I. Karakis, B. Sarov (Epidemiology Department), S. Ariad (Oncology Department), D. Benharroch (Pathology Department), Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel; D. Bourboulia, N. Dupin, R. Weiss, C. Boshoff, The Cancer Research Campaign (CRC) Viral Oncology Group, Departments of Oncology and Molecular Pathology, University College London, U.K.; J.-C. Zong, G. Hayward, Department of Pharmacology and Molecular Sciences, The Johns Hopkins School of Medicine, Baltimore, MD.
Correspondence to: Batia Sarov, Ph.D., M.P.H., Department of Epidemiology, Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel (e-mail: sbatia{at}bgumail.bgu.ac.il), or to Chris Boshoff, M.R.C.P., Ph.D., The CRC Viral Oncology Group, The Wolfson Institute for Biomedical Research, The Cruciform Building, University College London, Gower St., London WC1E 6BT, U.K (e-mail: c.boshoff{at}ucl.ac.uk). Correspondence regarding molecular variance can be addressed to Gary Hayward, Ph.D. (e-mail: ghayward{at}jhmi.edu).
Background: The incidence of classic Kaposi's sarcoma among Jews in Israel is among the highest in the developed world. Kaposi's sarcoma-associated herpesvirus (KSHV or human herpesvirus 8) is causally linked to Kaposi's sarcoma. Very little is known about the prevalence of KSHV in the Middle East or about the modes of transmission in Mediterranean countries. Methods: From 1992 through 1995, sera were obtained from 1648 adults who had tested positive for hepatitis B virus (HBV) surface antigen 20 years earlier at blood donations; sera were also obtained from 2403 of their family members. All sera were tested for anti-KSHV antibodies with the use of an indirect immunofluorescence assay. To analyze the effects of various factors on the risk of KSHV infection for both the HBV-positive cohort and their families, logistic regression for cluster data and generalized estimating equations were used. All statistical tests were two-sided. Results: Among family members, the seroprevalence of antibodies against KSHV was 9.9% (95% confidence interval [CI] = 8.7% to 11.1%); among the former blood donors who had tested positive for hepatitis B, it was 22% (95% CI = 19.9% to 24.1%). Overall, the best predictor of KSHV status was the place of birth. The most important risk factors found for both husband and wife to test KSHV positive were their own places of birth and their spouse's seropositivity. For a child to test positive, the most important risk factor was maternal seropositivity. Conclusions: The crude prevalence rate of KSHV among the Jewish population in Israel is 9.9%. Important routes of KSHV transmission in the families studied are spouse to spouse and mother to child. The presence of KSHV in Jews in Israel of all ethnic origins and their high incidence of reported Kaposi's sarcoma suggest that KSHV was introduced into the Jewish population prior to the major Diaspora.
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