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Previous Volume 340:1863-1871 June 17, 1999 Number 24 Next

	Full Text PDF Editorial by Jaffe, H. W. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Infection with human herpesvirus 8 (HHV-8) has been consistently linked to Kaposi's sarcoma, but its mode of transmission, association with other cancers, and interaction with the human immunodeficiency virus type 1 (HIV-1) are largely unknown.

Methods Between January 1992 and December 1997, we interviewed 3591 black patients with cancer in Johannesburg and Soweto, South Africa. Blood was tested for antibodies against HIV-1 and HHV-8 in 3344 of the patients. Antibodies against HHV-8 were detected with an indirect immunofluorescence assay. The intensity of the fluorescent signal correlated well with the titers of antibodies (P<0.001). The relations among the presence of anti–HHV-8 antibodies, sociodemographic and behavioral factors, type of cancer, and the presence or absence of coexistent HIV-1 infection were examined with the use of unconditional logistic-regression models.

Results Among the 3293 subjects with cancers other than Kaposi's sarcoma, the standardized seroprevalence of antibodies against HHV-8 was 32 percent, which did not differ significantly from the standardized seroprevalence among black blood donors. Among these 3293 patients, the prevalence of antibodies against HHV-8 increased with increasing age (P<0.001) and an increasing number of sexual partners (P=0.05) and decreased with increasing years of education (P=0.007); it was not strongly associated with HIV-1 infection. Anti–HHV-8 antibodies were more frequent among black than white blood donors (P<0.001). Among the 51 patients with Kaposi's sarcoma, the standardized seroprevalence of antibodies against HHV-8 was 83 percent, significantly higher than the prevalence among those without Kaposi's sarcoma (P<0.001). For 16 other specific types of cancer, including multiple myeloma (108 cases) and prostate cancer (202 cases), the variation in the standardized seroprevalence of antibodies against HHV-8 was not remarkable. At a given intensity of fluorescence of anti–HHV-8 antibodies, Kaposi's sarcoma was more frequent among HIV-1–positive patients than among those who were HIV-1–negative (P<0.001).

Conclusions Among black patients with cancer in South Africa, the seroprevalence of anti–HHV-8 antibodies is high and is specifically associated with Kaposi's sarcoma, particularly at high titers.

Source Information

From the South African Cancer Epidemiology Unit, National Cancer Registry (F.S., H.C., R.P.-N.), and the Departments of Anatomical Pathology (F.S., H.C., R.P.-N.) and Serology (U.J.), South African Institute for Medical Research — both in Johannesburg; the Imperial Cancer Research Fund Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom (V.B., R.N., G.R., D. Bull); and the Departments of Oncology and Molecular Pathology, University College London, London (D. Bourboulia, D.W., C.B., R.W.). Other authors were Moosa Patel, F.C.P.(S.A.), M.Med., Paul Ruff, M.B., B.Ch., M.Med., Werner R. Bezwoda, F.C.P., Ph.D., and Edna Retter, L.M.C. (University of the Witwatersrand, Johannesburg, South Africa); and Martin Hale, M.B., Ch.B., F.C.Path. (South African Institute for Medical Research, Johannesburg).

Address reprint requests to Dr. Sitas at the South African Institute for Medical Research, P.O. Box 1038, Johannesburg 2000, South Africa, or at freddys{at}mail.saimr.wits.ac.za.

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