Human herpesvirus 8 (HHV-8) is prevalent in Africa and parts of southern Europe, but less common elsewhere. It is analogous to its distant relative, the Epstein-Barr virus, in that it rarely causes disease in the immunocompetent host but is highly oncogenic when associated with immunosuppression or HIV-1 infection. HHV-8 infection is endemic in sub-Saharan Africa, where high seroprevalence rates of up to 58% in young children were found in Ghana, Tanzania, Cameroon, Uganda and Egypt. Paediatric HHV-8 transmission has been studied in various African populations. Frequent detection of the virus from oral secretions suggests the horizontal route is the most common way to acquire the virus during childhood. A clinical presentation characterized by a self-limited maculopapular rash and fever was associated with HHV-8 primary infection in Egyptian children.