Abstract:
Human herpes virus type 8 (HHV-8) is the causative agent of Kaposi’s sarcoma (KS).
We systematically reviewed literature published between 1998 and 2017, according to the PRISMA
guidelines, to understand the distribution of HHV-8 infection in Africa. More than two-thirds (64%)
of studies reported on seroprevalence and 29.3% on genotypes; 9.5% were on both seroprevalence
and genotypes. About 45% of African countries had data on HHV-8 seroprevalence exclusively,
and more than half (53%) had data on either seroprevalence or genotypes. Almost half (47%) of
the countries had no data on HHV-8 infection. There was high heterogeneity in the types of tests
and interpretation algorithms used in determining HHV-8 seropositivity across the different studies.
Generally, seroprevalence ranged from 2.0% in a group of young children in Eritrea to 100% in a small
group of individuals with KS in Central African Republic, and in a larger group of individuals with
KS in Morocco. Approximately 16% of studies reported on children. Difference in seroprevalence
across the African regions was not significant (95% CI, 2 = 0.86; p = 0.35), although specifically a
relatively significant level of infection was observed in HIV-infected children. About 38% of the
countries had data on K1 genotypes. K1 genotypes A, A5, B, C, F and Z occurred at frequencies
of 5.3%, 26.3%, 42.1%, 18.4%, 5.3% and 2.6%, respectively. Twenty-three percent of the countries
had data for K15 genotypes, and genotypes P, M and N occurred at frequencies of 52.2%, 39.1%,
and 8.7%, respectively. Data on HHV-8 inter-genotype recombinants in Africa are scanty. HHV-8 may
be endemic in the entire Africa continent but there is need for a harmonized testing protocol for a
better understanding of HHV-8 seropositivity. K1 genotypes A5 and B, and K15 genotypes P and M,
from Africa, should be considered in vaccine design efforts
