Jn. Martin et al., SEXUAL TRANSMISSION AND THE NATURAL-HISTORY OF HUMAN-HERPESVIRUS-8 INFECTION, The New England journal of medicine, 338(14), 1998, pp. 948-954
Background Although human herpesvirus 8 (HHV-8) has been suspected to
be the etiologic agent of Kaposi's sarcoma, little is known about its
seroprevalence in the population, its modes of transmission, and its n
atural history. Methods The San Francisco Men's Wealth Study, begun in
1984, is a study of a population-based sample of men in an area with
a high incidence of human immunodeficiency virus (HIV) infection. We s
tudied all 400 men infected at base line with HIV and a sample of 400
uninfected men, Base-line serum samples were assayed for antibodies to
HHV-8 latency-associated nuclear antigen (anti-LANA). In addition to
the seroprevalence and risk factors for anti-LANA seropositivity, we a
nalyzed the time to the development of Kaposi's sarcoma. Results Anti-
LANA antibodies were: found in 223 of 593 men (37.6 percent) who repor
ted any homosexual activity in the previous five years and in none of
195 exclusively heterosexual men, Anti-LANA seropositivity correlated
with a history of sexually transmitted diseases and had a linear assoc
iation with the number of male sexual-intercourse partners. Among the
men who were infected with both HIV and HHV-8 at base line, the 10-yea
r probability of Kaposi's sarcoma was 49.6 percent, Base-line anti-LAN
A seropositivity preceded and was independently associated with subseq
uent Kaposi's sarcoma, even after adjustment; for CD4 cell counts and
the number of homosexual partners. Conclusions The prevalence of HHV-8
infection is high among homosexual men, correlates with the number of
homosexual partners, and is temporally and independently associated w
ith Kaposi's sarcoma, These observations are further evidence that HHV
-8 has an etiologic Pole in Kaposi's sarcoma and is sexually transmitt
ed among men. (C) 1998 Massachusetts Medical Society.