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
Virology Laboratory, University College London Medical School, UK.
Lancet. 1995 Sep 23;346(8978):799-802. doi: 10.1016/s0140-6736(95)91619-9.
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.
卡波西肉瘤相关疱疹病毒（KSHV）在艾滋病相关卡波西肉瘤（KS）和“经典”卡波西肉瘤患者的活检样本中一直被发现。尽管这强烈提示KSHV在KS发病机制中起因果作用，但这一观察结果并不排除KSHV与其他疱疹病毒一样广泛分布且仅仅是这些病变中的“过客”的可能性。在此我们报告，在46例KS患者中的24例（52%）外周血单个核细胞中可检测到KSHV，但在134名献血者或26名未感染HIV的医院对照者中均未检测到。KSHV的检测率随免疫抑制程度增加而升高，这表现为与CD4阳性T细胞数量减少相关。此外，在未患KS的HIV感染者外周血细胞中检测到KSHV可预测随后KS病变的出现。对143例在首次（或仅有的）血样采集时未患KS的患者进行了中位时间为30个月的随访。在11例KSHV阳性患者中，6例出现了KS，而在132例KSHV阴性患者中仅有12例出现KS。这些发现与KSHV在KS中起致病作用相符。在HIV感染患者的痰液和咽拭子中很少检测到KSHV，这为该病毒明显有限的传播提供了一个潜在解释。
