Kaposi's sarcoma in the Gambia, West Africa is less frequent in human immunodeficiency virus type 2 than in human immunodeficiency virus type 1 infection despite a high prevalence of human herpesvirus 8.
OBJECTIVE
To investigate the distribution of Kaposi's sarcoma (KS) cases in patients with human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) infection in the Gambia; to document the prevalence of human herpesvirus 8 (HHV-8) infection in various population groups in the Gambia.


METHODS
A retrospective analysis of KS cases in hospital records at the Medical Research Council (MRC) hospital was performed, along with a cross-sectional survey of HHV-8 prevalence in hospital-based and community-based study population with polymerase chain reaction (PCR) and serologic assays.


RESULTS
After adjusting for gender and CD% at the first visit, HIV-1-positive patients were 12.4 times more likely to have KS than were HIV-2-positive patients. The prevalence of antibodies to HHV-8 and the HHV-8 genome was high in both HIV-1-positive and HIV-2-positive patients without KS. The prevalence of antibodies was also high in pregnant women who were HIV-1-positive, HIV-2-positive, or HIV-negative (73%, 83%, and 79%, respectively).


CONCLUSIONS
HHV-8 infection is widespread in the Gambia. In addition to immunosuppression and HHV-8 infection, other cofactors specifically related to HIV-1 rather than HIV-2 appear to be involved in the development of KS.
Ariyoshi
K
K
Medical Research Council Laboratories, The Gambia, West Africa. kariyoshi@gam.healthnet.org
Schim van der Loeff
M
M
Cook
P
P
Whitby
D
D
Corrah
T
T
Jaffar
S
S
Cham
F
F
Sabally
S
S
O'Donovan
D
D
Weiss
R A
RA
Schulz
T F
TF
Whittle
H
H
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000821:virology*; D000293:Adolescent; D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005714:Gambia / Q000453:epidemiology; D015497:HIV-1; D015498:HIV-2; D019288:Herpesvirus 8, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology*