HUMAN HERPES VIRUS-8 DNA IN BRONCHOALVEOLAR LAVAGE SAMPLES FROM PATIENTS WITH AIDS-ASSOCIATED PULMONARY KAPOSIS-SARCOMA

Kaposi's sarcoma (KS) is the most frequent AIDS-associated neoplasm, a nd often disseminates to visceral organs, including the lungs. An ante -mortem diagnosis of pulmonary KS is difficult. Recently, DNA sequence s resembling a new human herpes virus (HHV-8), have been identified in various forms of KS. We hypothesized that these sequences are present in samples obtained by bronchoalveolar lavage (BAL) in patients with pulmonary KS. Utilizing a nested polymerase chain reaction (PCR), 7/12 BAL cell samples from HIV-infected patients with endobronchial KS wer e positive for HHV-8 DNA. In contrast, only 2/39 samples from HIV-infe cted patients without evidence of KS were positive (p=0.007), Detectio n of HHV-8 in BAL cells of patients with pulmonary KS was highly speci fic (95%), with a sensitivity of 58% and a positive predictive value o f 78%. In conclusion, HHV-8 is associated with pulmonary KS, and PCR a mplification of HHV-8 in BAL cells provides a non-invasive method with a high positive predictive value.