Prevalence of Kaposi sarcoma-associated herpesvirus infection in homosexual men at beginning of and during the HIV epidemic.

Abstract

Research on Kaposi sarcoma–associated herpesvirus (KSHV), also known as human herpesvirus 8, has shown it is a necessary etiologic agent of Kaposi sarcoma (KS).^1-5 It has also been shown that the prevalence of KSHV parallels the prevalence of KS. For example, in the United States, KSHV infection is common in homosexual men (prevalence, 15%-60%) but infrequent in heterosexual groups (0%-9%), paralleling the KS pattern.^2,6-8 It has also been suggested that changes in KSHV prevalence in homosexual men might explain changes in KS incidence over the past 20 years in the United States; eg, at least 1 report has suggested that a KSHV epidemic evolved concurrently with the human immunodeficiency virus (HIV) epidemic in the early 1980s.⁴ Similarly, an analysis of risk factors for KSHV in homosexual men suggested that contact with an HIV-infected partner or a partner with KS is associated with KSHV infection, implying the HIV epidemic may have been a major factor in a KSHV epidemic.⁹ It has also been suggested that a decline in new KS diagnoses, even before the highly active antiretroviral therapy (HAART) era, may have been due to decline in transmission of the "KS agent."¹⁰