PROCAARE: RELATED EPIDEMICS--Kaposi's sarcoma--KSHV

[Albert Shaw <ashaw@usa.healthnet.org>]

KEYWORDS--KAPOSI'S SARCOMA/KSHV/PROSTATE/SEMEN/POLYMERASE CHAIN REACTION
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Reference: Monini, P., De Lellis, L., Fabris, M., Rigolin, F., Cassai, E. 
(1996).  Kaposi's sarcoma-associated herpesvirus DNA sequences in 
prostate tissue and human semen.  New Engl. J. Med. 334: 1168-72.

This study examined the prevalence of Kaposi's sarcoma-associated 
herpesvirus (KSHV) DNA sequences detected by the polymerase chain 
reaction (PCR) in tissue from the urogenital tract of 100 immunocompetent 
adults; in addition, ejaculates from 43 immunocompetent Italian men 
undergoing surgery for varicocele.  

KSHV sequences were amplified in 2/20 urinary tract specimens (10%), 3/46 
samples from the female genital tract (6.5%), 4/18 samples from the glans 
or foreskin (22%), 7/16 prostate specimens (44%) and 30/33 ejaculates 
(91%).  Only 1/18 samples from normal skin and 1/14 peripheral blood 
mononuclear cell (PBMC) preparations contained KSHV DNA.  Because these 
samples were evaluated in a nonblinded fashion, these results were 
confirmed in a blinded analysis of a subset of 10 semen, 8 skin, and 14 
PBMC samples.  Five KSHV-positive semen samples were further analyzed; 
fractions enriched in sperm heads or urothelial cells were separately 
amplified.  In 3/5 cases, KSHV DNA was found only in the urothelial cell 
fraction.

The high frequency of KSHV sequences detected in prostate tissue and 
semen is consistent with the hypothesis of Kaposi's sarcoma as a sexually 
transmitted disease which might be exacerbated by HIV infection (either 
through reinfection or reactivation in susceptible groups).  Still 
unexplained is the increased incidence of  Kaposi's sarcoma in 
Mediterranean and subequitorial African populations.