McDonald, Alicia Catania
(2008)
The Evaluation of Human Herpesvius 8 Infection in Tobago.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
HHV-8 seropositivity was associated with prevalent prostate cancer among African-Caribbean Tobago men (Odds ratio [O.R.] = 2.24; 95% confidence interval [C.I.], 1.29-3.90). To understand this association, HHV-8 seropositivity among African-Caribbean Tobago women, modes of HHV-8 sexual transmission, the natural history of HHV-8 seropositivity, and the relationship between HHV-8 and incident prostate cancer were examined. A cross-sectional study was conducted in 213 Tobago women, ages 18-65 years. Age-specific rates were compared to those previously observed in men. Logistic regression analyses were performed to determine the association between HHV-8 seropositivity and sexual behaviors among women. A 9-year prospective cohort study was conducted among 407 Tobago men at risk for incident prostate cancer, ages 40-81 years. HHV-8 seroconversion and seroreversion rates and their 95% C.I. were calculated using a Poisson distribution. A case-cohort study was conducted among 90 and 407 Tobago men, ages 40-81 years, with incident prostate cancer and at risk for incident prostate cancer, respectively. Cox proportional hazards modeling for case-cohort design was used to examine the association between baseline HHV-8 seropositivity and incident prostate cancer. All serum/plasma were tested for HHV-8 seropositivity by immunofluorescence assay. Among women, HHV-8 seroprevalence was 14.1%, with no difference with men of similar age (p-value = .741). There was a significant but minimal association between HHV-8 seropositivity and age less than and equal to 17 years at first sexual intercourse among women (O.R. = 2.51, 95% C.I. = 1.09-5.78). Among men at risk for incident prostate cancer, HHV-8 seroconversion and seroreversion rates were 0.5 (95% C.I., 0.22-0.99) and 2.52 (95% C.I., 1.09-4.96) per 100 person-years, respectively. There were inverse associations between baseline HHV-8 seropositivity and screen-detected incident prostate cancer when age and baseline prostate cancer screening results (Hazard ratio [H.R.] = 0.454, 95% C.I., 0.221 - 0.933) and age (H.R. = 0.517, 95% C.I., 0.262 - 1.020) were considered.Sexual activity may not be the predominant mode of HHV-8 transmission among women. HHV-8 is probably acquired at younger ages, less than 40 years among men. HHV-8 seropositivity may not be related to prostate cancer incidence. The public health significance of these studies is to reduce HHV-8 infection and prostate cancer in Tobago.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
28 September 2008 |
| Date Type: |
Completion |
| Defense Date: |
18 July 2008 |
| Approval Date: |
28 September 2008 |
| Submission Date: |
29 July 2008 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Human herpesvirus 8; Caribbean; seropositivity; prostate cancer |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-07292008-180906/, etd-07292008-180906 |
| Date Deposited: |
10 Nov 2011 19:54 |
| Last Modified: |
15 Nov 2016 13:47 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/8710 |
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