Abstract

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 1,092 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, HIV 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). Recipients of a single short-stored HHV-8-antibody-positive blood unit were twice as likely to die (AHR, 2.19; 95% CI, 1.06-4.53) as recipients of a single short-stored HHV-8-antibody-negative blood unit.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.