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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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Prevalence of Kaposi's Sarcoma-Associated Herpesvirus Infection in Homosexual Men at Beginning of and During the HIV Epidemic [Osmond DH et al. JAMA 2002;287:221] The authors determined the prevalence of Kaposi's sarcoma virus (HHV-8) in various cohorts of gay men in San Francisco for three time periods: 1978-79, 1984-85 and 1995-96. The cohorts included the San Francisco City Clinic Cohort, the San Francisco Men's Health Study, and the San Francisco Young Men's Health Study. The overall prevalence of antibody was 26.5% for 1978-79, 29.6% for 1984-85, and 26.4% for 1995-96. The prevalence of HIV in gay men during this interval decreased from 49.5% in 1984-85 to 17.6% in 1992-93. The authors conclude that HHV-8 was highly prevalent in gay men in San Francisco when the HIV epidemic began and that its prevalence has persisted at a nearly constant level.
Comment: Prior studies have indicated that AIDS-associated KS declined in the U.S. prior to HAART and the presumed cause was a reduction in transmission in HHV-8. The data here do not support this conclusion. Further, the mechanism of transmission of this agent is still unclear. The authors note that the prevalence of HHV-8 did not decline at a time when the prevalence of HIV showed substantial decline that accompanied substantial risk reduction in unprotected anal intercourse in gay men in San Francisco. The authors postulate that oral sex might be important; kissing appears to be a less likely culprit due to the low prevalence of this virus in heterosexual persons (0-9%). If their hypothesis is correct, the assumed vehicle for transmission is saliva and the insertive partner is the one at substantial risk.
posted 1/28/2002





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