Detection of Kaposi sarcoma associated herpesvirus in peripheral blood of HIV-infected individuals and progression to Kaposi's sarcoma

Kaposi sarcoma-associated herpesvirus (KSHV) is consistently found in biopsy samples from patients with AIDS-related and "classical" Kaposi's sarcoma (KS). Although highly suggestive of a causal role of KSHV in the pathogenesis of KS, this observation does not exclude the possibility...

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Bibliographic Details
Published in:	The Lancet (British edition) Vol. 346; no. 8978; p. 799
Main Authors:	Whitby, D, Howard, M R, Tenant-Flowers, M, Brink, N S, Copas, A, Boshoff, C, Hatzioannou, T, Suggett, F E, Aldam, D M, Denton, A S
Format:	Journal Article
Language:	English
Published:	England 23-09-1995
Subjects:	Adult AIDS-Related Opportunistic Infections - virology CD4 Lymphocyte Count Cohort Studies Disease Progression Feces - microbiology Female Follow-Up Studies Forecasting Herpesviridae - isolation & purification Herpesvirus 4, Human - isolation & purification HIV Infections - blood HIV Infections - virology HIV Seronegativity Humans Leukocytes, Mononuclear - virology Male Middle Aged Pharynx - virology Sarcoma, Kaposi - blood Sarcoma, Kaposi - virology Sputum - virology Viremia - microbiology
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Summary:	Kaposi sarcoma-associated herpesvirus (KSHV) is consistently found in biopsy samples from patients with AIDS-related and "classical" Kaposi's sarcoma (KS). Although highly suggestive of a causal role of KSHV in the pathogenesis of KS, this observation does not exclude the possibility that KSHV, like other herpesviruses, is widely distributed and is a mere "passenger" in these lesions. Here we report that KSHV was detectable in peripheral blood mononuclear cells of 24/46 (52%) of KS patients, but in none of 134 blood donors or 26 HIV-uninfected hospital controls. KSHV detection increased with immunosuppression, as shown by a correlation with a reduced number of CD4-positive T-cells. Moreover, KSHV detection in peripheral blood cells of HIV-infected individuals without KS predicted the subsequent appearance of KS lesions. 143 patients who did not have KS at the time of their first (or only) blood sample were followed up for a median of 30 months. Of the 11 who had been KSHV positive 6 developed KS compared with only 12 out of 132 who were KSHV negative. These findings are compatible with a causative role of KSHV in KS. KSHV was rarely detected in sputum and throat swabs of HIV-infected patients, providing a potential explanation for the apparently limited spread of this virus.
ISSN:	0140-6736
DOI:	10.1016/S0140-6736(95)91619-9