Melbye M, Cook P M, Hjalgrim H, Begtrup K, Simpson G R, Biggar R J, Ebbesen P, Schulz T F
Department of Epidemiology Research, Danish Epidemiology Science Center, Statens Serum Institut, Copenhagen.
Int J Cancer. 1998 Aug 12;77(4):543-8. doi: 10.1002/(sici)1097-0215(19980812)77:4<543::aid-ijc12>3.0.co;2-7.
A newly identified herpesvirus has been associated with Kaposi's sarcoma. We determined risk factors for Kaposi's-sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV-8) seropositivity and incidence of infection over time in a cohort of Danish homosexual men followed from 1981 to 1996. Antibodies to a latent nuclear (LANA) and a structural (orf65) antigen of KSHV/HHV-8 were measured by immunofluorescence and ELISA/WB respectively. Through linkage with the national AIDS registry, all cohort members diagnosed with AIDS as of September 1996 were identified and their hospital records were scrutinized to record all diagnoses of KS. Overall, 21.1% (52/246) of the men were KSHV/HHV-8-seropositive in 1981. Among the initially seronegative, the rate of KSHV/HHV-8 seroconversion was highest between 1981 and 1982 and declined steadily thereafter. In a multivariate analysis of the status at enrollment in 1981, KSHV/HHV-8 seropositivity was not associated with age but was independently associated both with number of receptive anal intercourses (OR = 2.83; p = 0.03) and with sex with US men (OR = 2.27; p < 0.05). In a multivariate analysis of follow-up data, risk of KSHV/HHV-8 seroconversion was independently associated with having visited homosexual communities in the United States, and current HIV-positive status. More than 5 years' homosexual experience was associated with an insignificantly increased risk (RR = 2.68). KS occurred only in HIV-positive men who were KSHV/HHV-8-positive at or prior to their KS diagnosis. In conclusion, KSHV/HHV-8 appears to be sexually transmitted, probably by receptive anal intercourse, and may have been introduced to Danish homosexual men via sex with US men. The epidemic of KSHV/HHV-8 is now declining. These findings are concordant with the view that KSHV/HHV-8 may have been actively spread simultaneously with and by the same activities that lead to the spread of HIV.
一种新发现的疱疹病毒与卡波西肉瘤有关。我们在一组1981年至1996年随访的丹麦同性恋男性队列中，确定了卡波西肉瘤相关疱疹病毒/人类疱疹病毒8型（KSHV/HHV-8）血清阳性的危险因素以及随时间推移的感染发生率。分别通过免疫荧光法和ELISA/WB法检测了针对KSHV/HHV-8的一种潜伏核（LANA）抗原和一种结构（orf65）抗原的抗体。通过与国家艾滋病登记处的关联，确定了截至1996年9月所有被诊断为艾滋病的队列成员，并仔细查阅了他们的医院记录以记录所有卡波西肉瘤的诊断情况。总体而言，1981年21.1%（52/246）的男性KSHV/HHV-8血清呈阳性。在最初血清阴性的人群中，KSHV/HHV-8血清转化发生率在1981年至1982年间最高，此后稳步下降。在对1981年入组时状况的多变量分析中，KSHV/HHV-8血清阳性与年龄无关，但与接受性肛交次数（OR = 2.83；p = 0.03）以及与美国男性发生性行为（OR = 2.27；p < 0.05）均独立相关。在对随访数据的多变量分析中，KSHV/HHV-8血清转化风险与曾到访美国同性恋社区以及当前HIV阳性状态独立相关。超过5年的同性恋经历与风险略有增加相关（RR = 2.68）。卡波西肉瘤仅发生在卡波西肉瘤诊断时或诊断前KSHV/HHV-8阳性的HIV阳性男性中。总之，KSHV/HHV-8似乎通过性传播，可能是通过接受性肛交，并且可能是通过与美国男性发生性行为而传播给丹麦同性恋男性的。KSHV/HHV-8的流行目前正在下降。这些发现与KSHV/HHV-8可能与导致HIV传播的相同活动同时并通过这些活动而被积极传播的观点一致。
