title: Molecular characterization of Kaposi's sarcoma associated herpesvirus (KSHV) from patients with AIDS-associated Kaposi's sarcoma in Sao Paulo, Brazil.
abstract: BACKGROUND
  Kaposi's sarcoma (KS) is caused by Kaposi's sarcoma associated herpesvirus (KSHV/HHV-8), the eighth Herpesvirus found to infect humans. The molecular epidemiology of KSHV is related closely to ethnicity and geographical location of studied populations. There is little epidemiological and molecular information about KSHV strains circulating in Brazil.
  
  
  OBJECTIVE
  To characterize KSHV strains isolated from AIDS patients with Kaposi's sarcoma (AIDS-KS) in Sao Paulo, Brazil, and to examine associations between KSHV subtypes, ethnicity and HIV risk categories.
  
  
  METHODS
  AIDS-KS patients were recruited consecutively at the largest AIDS reference hospital in Sao Paulo. Fragments (420 bp) of the VR1 and VR2 regions of KSHV open reading frame (ORF) K1 were amplified by nested PCR and sequenced directly.
  
  
  RESULTS
  We analysed 37 samples from 33 patients, and found subtypes A-C in 48%, 21% and 30% of patients respectively, including two patients infected with subtype A5, a first report from Brazil. Sexual orientation was associated with subtype: 12/14 (86%) patients with subtype A were male homo/bisexual, compared with 3/8 (38%) among patients infected with subtype C (P = 0.05). A higher proportion of male patients with subtype C were of Caucasian origin (7/8 (87%)), compared with 7/16 (44%) among male patients with subtype A (P = 0.08).
  
  
  CONCLUSIONS
  This first detailed report of KSHV subtypes among AIDS-KS patients in Brazil reports the first isolation of KSHV subtype A5 in this country, and suggests KSHV strain transmission between different ethnic groups, and association of specific strains with sexual orientation.
authors.affiliation: Instituto de Infectologia Emílio Ribas Hospital, São Paulo, Brazil. marie.nascimento@lshtm.ac.uk
authors.forename: Maria C
authors.initials: MC
authors.lastname: Nascimento
authors.forename: Natalie
authors.initials: N
authors.lastname: Wilder
authors.forename: Claudio S
authors.initials: CS
authors.lastname: Pannuti
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.forename: Philippe
authors.initials: P
authors.lastname: Mayaud
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology*; D000328:Adult; D044383:Black People; D001938:Brazil / Q000453:epidemiology; D005260:Female; D019288:Herpesvirus 8, Human / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007199:Indians, South American; D008297:Male; D008969:Molecular Sequence Data; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology*; D017422:Sequence Analysis, DNA; D044465:White People