DETECTION OF HERPESVIRUS-LIKE DNA SEQUENCES IN KAPOSI'S SARCOMA IN PATIENTS WITH AND THOSE WITHOUT HIV INFECTION

Abstract

Background. Herpesvirus-like DNA sequenc- es have recently been found in lesions from patients with Kaposi's sarcoma and the acquired immunodeficiency syn- drome (AIDS). It is not known whether these sequences are also present in classic Kaposi's sarcoma or in the Ka- posi's sarcoma that occurs in homosexual men who are seronegative for the human immunodeficiency virus (HIV). Methods. We analyzed DNA in tissue samples from patients with AIDS-associated Kaposi's sarcoma, patients with classic Kaposi's sarcoma, and HIV-seronegative ho- mosexual men with Kaposi's sarcoma. We also analyzed DNA in samples of uninvolved tissue from these patients and in control tissue from healthy subjects. All samples were tested blindly by polymerase chain reaction (PCR) with specific primers to amplify KS330 233 , a herpesvirus- like DNA sequence. Results. The KS330 233 PCR product was found in 20 of 21 tissue samples (95 percent) from the patients with Kaposi's sarcoma, including 10 of the 11 samples from the patients with AIDS-associated Kaposi's sarcoma, all 6 samples from the patients with classic Kaposi's sarco- ma, and all 4 samples from the HIV-negative homosexual men with Kaposi's sarcoma. Only 1 of the 21 control sam- ples (5 percent) was positive (odds ratio, 400; 95 percent confidence interval, 19 to 17,300). Of the 14 samples of uninvolved skin from the patients with Kaposi's sarcoma, 3 were positive for KS330 233 . Representative PCR-prod- uct sequences were more than 98 percent identical for the three types of Kaposi's sarcoma, suggesting that all three are caused by the same agent. Conclusions. The same herpesvirus-like DNA se- quences are present in AIDS-associated Kaposi's sarco- ma, classic Kaposi's sarcoma, and the Kaposi's sarcoma that occurs in HIV-negative homosexual men. Therefore, this presumably new human herpesvirus is not solely an opportunistic infection in patients with AIDS, and the three forms of Kaposi's sarcoma may be caused by the same infectious agent. (N Engl J Med 1995;332:1181-5.)