Disseminated Kaposi's Sarcoma in Homosexual Men

Abstract

Nineteen cases from an epidemic of disseminated Kaposi''s sarcoma in homosexual men were studied by clinical, virologic, immunologic and genetic methods. The patients were all male homosexuals ranging in age from 29 to 52 yr, with histories of multiple sexually transmitted diseases and exposure to prescription and recreational drugs. Sites of disease included skin (16 of 19 patients), lymph nodes (13 patients), gastrointestinal tract (12 patients), spleen (3 patients), and lung (1 patient). Most patients had elevated levels of serum Ig, positive antibody titers to hepatitis A and B virus, cytomegalovirus and Epstein-Barr virus, and impairment of cell-mediated immunologic reactions. The frequency of HLA-DR5 in these patients was significantly elevated. Two of the 19 patients died. Although the precise cause of this epidemic is unknown, it is likely that a genetic predisposition, an acquired immunoregulatory defect, and 1 or more infectious agents and drugs may be involved.