Moore P S, Chang Y
Division of Epidemiology, School of Public Health, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
N Engl J Med. 1995 May 4;332(18):1181-5. doi: 10.1056/NEJM199505043321801.
Herpesvirus-like DNA sequences have recently been found in lesions from patients with Kaposi's sarcoma and the acquired immunodeficiency syndrome (AIDS). It is not known whether these sequences are also present in classic Kaposi's sarcoma or in the Kaposi's sarcoma that occurs in homosexual men who are seronegative for the human immunodeficiency virus (HIV).
We analyzed DNA in tissue samples from patients with AIDS-associated Kaposi's sarcoma, patients with classic Kaposi's sarcoma, and HIV-seronegative homosexual 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.
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 sarcoma, and all 4 samples from the HIV-negative homosexual men with Kaposi's sarcoma. Only 1 of the 21 control samples (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-product 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.
The same herpesvirus-like DNA sequences are present in AIDS-associated Kaposi's sarcoma, 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.
最近在卡波西肉瘤患者及获得性免疫缺陷综合征(艾滋病)患者的病变组织中发现了类疱疹病毒DNA序列。目前尚不清楚这些序列是否也存在于经典型卡波西肉瘤或感染人类免疫缺陷病毒(HIV)血清学阴性的同性恋男性所患的卡波西肉瘤中。
我们分析了艾滋病相关卡波西肉瘤患者、经典型卡波西肉瘤患者以及HIV血清学阴性的同性恋卡波西肉瘤患者的组织样本中的DNA。我们还分析了这些患者未受累组织样本以及健康受试者对照组织中的DNA。所有样本均采用聚合酶链反应(PCR)及特异性引物进行盲法检测,以扩增类疱疹病毒DNA序列KS330(233)。
在21例卡波西肉瘤患者的组织样本中,有20例(95%)检测到KS330(233) PCR产物,其中包括11例艾滋病相关卡波西肉瘤患者样本中的10例、6例经典型卡波西肉瘤患者的所有样本以及4例HIV阴性同性恋卡波西肉瘤患者的所有样本。21例对照样本中仅有1例(5%)呈阳性(优势比为400;95%置信区间为19至17300)。在14例卡波西肉瘤患者未受累皮肤样本中,有3例KS330(233)呈阳性。三种类型卡波西肉瘤的代表性PCR产物序列相似度超过98%,表明这三种类型可能由同一病原体引起。
艾滋病相关卡波西肉瘤、经典型卡波西肉瘤以及HIV阴性同性恋男性所患的卡波西肉瘤中均存在相同的类疱疹病毒DNA序列。因此,这种可能是新型的人类疱疹病毒并非仅为艾滋病患者的机会性感染,三种类型的卡波西肉瘤可能由同一感染病原体引起。