KAPOSIS-SARCOMA-ASSOCIATED HERPESVIRUS IS DETECTED IN PERIPHERAL-BLOOD MONONUCLEAR-CELLS OF HIV-INFECTED HOMOSEXUALS MORE OFTEN THAN IN HETEROSEXUALS

PURPOSE The Kaposi's-sarcoma-associated herpesvirus is thought likely to play an important part in the pathogenesis of Kaposi's sarcoma, whi ch is the most common tumor in AIDS patients. To determine whether per ipheral blood is also infected by the virus, we prospectively tested m ononuclear cells from HIV-infected individuals, both with and without Kaposi's sarcoma. PATIENTS AND METHODS Thirty-three patients with AIDS were studied Twenty-three were homosexuals, and 10 of these patients had Kaposi's sarcoma. ALL 10 nonhomosexual patients were free of Kapos i's sarcoma. PCR amplification of peripheral blood mononuclear cells w as performed for a 233-base-pair segment of Kaposi's-sarcoma-associate d herpesvirus on all patients. Fisher's exact test was used to compare the patients groups. RESULTS Kaposi's-sarcoma-associated herpesvirus sequences were detected in the peripheral blood mononuclear cells of h omosexual men both with (7/10) and without (5/13) Kaposi's sarcoma. Ho wever, none of the nonhomosexual patients (0/10) had detectable virus. Therefore, those with Kaposi's sarcoma are at greater risk for Kaposi 's-sarcoma-associated herpesvirus infection than patients without Kapo si's sarcoma, and among HIV-positive patients without Kaposi's sarcoma , homosexuals are more likely to have detectable Kaposi's-sarcoma-asso ciated herpesvirus than are nonhomosexuals. In the homosexual patients , the presence of virus was unrelated to total CD4+ cell counts. A com parative dilutional analysis showed that the nonhomosexual patients ha d a low viral load in their peripheral blood mononuclear cells relativ e to most homosexuals with Kaposi's sarcoma Sequential studies an two patients revealed clearing of the virus while on therapy; one patient was treated for HIV with the protease inhibitor indinavir, and the oth er patient was treated for Kaposi's sarcoma with liposomal doxorubicin . CONCLUSIONS These results indicate that Kaposi's-sarcoma-associated herpesvirus is harbored in peripheral blood mononuclear cells of HIV-i nfected patients, and that the rates of infection are significantly hi gher in homosexual men compared with their nonhomosexual counterparts. The significance of viral clearing in response to therapy is unknown but warrants further study, as prophylactic treatment for this virus m ight alter the occurrence of Kaposi's sarcoma in this susceptible pati ent population.