Risk factors for Kaposi's sarcoma among HHV-8 seropositive homosexual men with AIDS.
Kaposi's sarcoma (KS) is a frequent complication of the acquired immunodeficiency syndrome (AIDS) in homosexual men. Risk factors for developing this malignancy are uncertain, other than immunosuppression and coinfection with human herpesvirus 8 (HHV-8). We therefore examined factors associated with KS in a cross-sectional analysis of 99 cases among 503 HHV-8 seropositive homosexual men with AIDS. Data were collected by computer-assisted personal interviews and medical chart reviews. HHV-8 seroreactivity was determined by enzyme-linked immunosorbent assay for antibodies against HHV-8 K8.1 glycoprotein. KS was significantly less common in blacks compared to whites [risk ratio (RR) = 0.4; 95% CI = 0.2 =0.8] and more common in subjects who had completed college (RR = 1.7; 95% CI = 1.1-2.7) or had annual income greater than dollar 30,000 (RR = 1.5; 95% CI = 1.1-2.2). KS was less common in cigarette smokers (RR = 0.6; 95% CI = 0.5-0.9) and users of crack cocaine (RR = 0.4; 95% CI = 0.1-0.8). KS was less common in bisexual men compared to men who were exclusively homosexual (estimated RR = 0.6; 95% CI = 0.4-0.9) and inversely associated with number of female partners. KS was also less common in men who had received pay for sex (RR = 0.6; 95% CI = 0.4-1.0). These cross-sectional associations could be biased by potential differences in relative timing of HHV-8 and HIV infection, a postulated determinant of KS risk. Alternatively, our findings may reflect factors protective against KS in individuals infected with HHV-8. Future research should focus on identifying practical measures for countering KS that do not increase the risk of other diseases.
Nawar
Eric
E
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Mbulaiteye
Sam M
SM
Gallant
Joel E
JE
Wohl
David A
DA
Ardini
Marianne
M
Hendershot
Tabitha
T
Goedert
James J
JJ
Rabkin
Charles S
CS
D000163:Acquired Immunodeficiency Syndrome / Q000821:virology*; D000328:Adult; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D006023:Glycoproteins / Q000276:immunology / Q000378:metabolism; D006679:HIV Seropositivity / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000821:virology*; D019562:Viral Load; D014764:Viral Proteins / Q000276:immunology / Q000378:metabolism
D006023:Glycoproteins; C113454:K8.1 protein, Human herpesvirus 8; D014764:Viral Proteins