Sitas F, Newton R
National Cancer Registry and Cancer Epidemiology Research Group, Department of Anatomical Pathology, South African Institute for Medical Research, University of the Witwatersrand, Johannesburg.
J Natl Cancer Inst Monogr. 2001(28):1-4. doi: 10.1093/oxfordjournals.jncimonographs.a024250.
Kaposi's sarcoma was endemic in South Africa even before the advent of the human immunodeficiency virus (HIV). Between 1988 and 1996, the incidence of Kaposi's sarcoma in South Africa has risen at least threefold and continues to increase as the HIV epidemic grows. Research from South Africa has shown that infection with human herpesvirus 8 (HHV8) is associated with Kaposi's sarcoma but not with any other major cancer site or type. In addition, the risk of Kaposi's sarcoma increases with increasing antibody titer to HHV8, but, for a given titer, the risk is greater in HIV-seropositive compared with HIV-seronegative individuals. The age- and sex-standardized seroprevalence of HHV8 in black South African hospital patients was found to be slightly more than 30%; the seroprevalence of HHV8 increased with age and was similar in men and in women. The modes of transmission of HHV8 are yet to be fully elucidated. Limited evidence exists for sexual transmission in black South African adults, but mother-to-child and person-to-person transmission in childhood is also likely. Furthermore, the seroprevalence of HHV8 decreases with increasing levels of education and is lower in whites than in blacks, suggesting that factors associated with poverty may be important determinants of transmission. Future research should focus on risk factors for Kaposi's sarcoma in HHV8-infected individuals, on determinants and mode of transmission of HHV8, and on the elucidation of the effect of primary HHV8 infection in adults and in children.
卡波西肉瘤在人类免疫缺陷病毒（HIV）出现之前就在南非流行。1988年至1996年间，南非卡波西肉瘤的发病率至少上升了三倍，并且随着HIV疫情的发展仍在继续增加。南非的研究表明，人类疱疹病毒8型（HHV8）感染与卡波西肉瘤有关，但与任何其他主要癌症部位或类型无关。此外，卡波西肉瘤的风险随着对HHV8抗体滴度的增加而增加，但是对于给定的滴度，HIV血清阳性个体的风险高于HIV血清阴性个体。在南非黑人医院患者中，HHV8的年龄和性别标准化血清阳性率略高于30%；HHV8的血清阳性率随年龄增加，男性和女性相似。HHV8的传播方式尚未完全阐明。在南非黑人成年人中，有有限的证据表明存在性传播，但母婴传播和儿童期的人际传播也很可能。此外，HHV8的血清阳性率随着教育水平的提高而降低，在白人中低于黑人，这表明与贫困相关的因素可能是传播的重要决定因素。未来的研究应关注HHV8感染个体中卡波西肉瘤的危险因素、HHV8的决定因素和传播方式，以及阐明原发性HHV8感染在成人和儿童中的影响。
