Infection with Kaposi's sarcoma-associated herpesvirus among families of patients with classic Kaposi's sarcoma.
BACKGROUND
Classic Kaposi's sarcoma (CKS) primarily affects elderly Mediterranean or Eastern European men. Incidence rates of CKS in Israel are among the world's highest. In practically all cases, antibodies against Kaposi's sarcoma-associated herpesvirus (KSHV) can be detected. A relatively high seroprevalence rate of KSHV in Israel generally correlates with the incidence of CKS. A sexual mode of virus transmission is recognized among homosexual men, whereas the precise transmission routes in the heterosexual population and those with CKS are still unclear.


OBJECTIVE
To better assess the transmission routes of KSHV in Israeli patients with CKS and their first-degree relatives as compared with a control group.


METHODS
Serum was collected from all study participants and tested for KSHV antibodies by means of latent and lytic immunofluorescence assays. An open reading frame 65 (ORF65) Western blot assay was applied as a confirmatory tool.


METHODS
Three dermatological departments in Israel.


METHODS
Sixty-four Jewish patients with CKS, 143 of their first-degree relatives, and 186 hospital-based control subjects.


RESULTS
Seropositivity to KSHV was detected in 62 (96.9%) of the patients with CKS, in 56 (39.2%) of their first-degree relatives, and in only 21 (11.3%) of the hospital controls (P<.001). The specific relationship with the index patient (spouse, offspring, or sibling) had no significant effect on the prevalence of serpositivity in the family members.


CONCLUSIONS
Our serologic evidence of familial clustering of KSHV infection suggests a predominantly nonsexual horizontal transmission route of the virus.
Guttman-Yassky
Emma
E
Department of Dermatology, Rambam Medical Center and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
Kra-Oz
Zippi
Z
Dubnov
Jonathan
J
Friedman-Birnbaum
Rachel
R
Segal
Isic
I
Zaltzman
Neli
N
Roth
Tova
T
Schwartz
Fidi
F
Linn
Shai
S
Rozenman
Dganit
D
David
Michael
M
Silbermann
Michael
M
Barchana
Micha
M
Bergman
Reuven
R
Sarid
Ronit
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D016022:Case-Control Studies; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D019288:Herpesvirus 8, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012514:Sarcoma, Kaposi / Q000097:blood / Q000453:epidemiology* / Q000821:virology*; D016036:Seroepidemiologic Studies
D000914:Antibodies, Viral