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Yuan Chang, MD; John Ziegler, MD; Henry Wabinga, MD; Edward Katangole-Mbidde, MD; Chris Boshoff, MD; Thomas Schulz, MD; Denise Whitby, MD; Dawn Maddalena; Harold W. Jaffe, MD; Robin A. Weiss, MD; Patrick S. Moore, MD

Arch Intern Med. 1996;156(2):202-204.

Abstract
Background
Endemic Kaposi's sarcoma (KS) is a clinically and epidemiologically distinct human immunodeficiency virus negative form of KS occurring in Africa. Kaposi's sarcoma is now the most frequently reported cancer in some areas of Africa.

Objective
To determine if a KS-associated herpes-virus (KSHV) is present in both endemic HIV-seronegative and HIV-seropositive KS lesions from African patients.

Methods
Paraffin-embedded tissue specimens from Ugandan patients with KS and non-KS tumor control patients attending a university-based oncology clinic were examined in a blinded case-control study. Tissue DNA specimens were examined for detectable KSHV genome by nested polymerase chain reaction performed at two independent laboratories.

Results
We identified KSHV in 17 (85%) of 20 KS tissue specimens from HIV-seronegative patients and 22 (92%) of 24 KS tissue specimens from HIV-infected persons. Kaposi's sarcoma lesions from four HIV-infected persons and four HIV-seronegative persons were positive for KSHV. Unlike previous studies in North America and Europe, three (14%) of 22 non-KS cancer control patients' tissue specimens were also positive for KSHV that resulted in an overall odds ratio of 49.2 (95% confidence interval, 9.1 to 335) for detecting KSHV in KS lesions from patients in Uganda.

Conclusion
As in North America and Europe, KSHV infection is strongly associated with both HIV-seropositive and HIV-seronegative KS in Africa. However, it is likely that infection with this virus is more highly prevalent in Uganda.

(Arch Intern Med. 1996;156:202-204)

Author Affiliations
the Uganda Kaposi's Sarcoma Study Group

From the Department of Pathology (Dr Chang and Ms Maddalena) and Division of Epidemiology, School of Public Health (Dr Moore), Columbia University, New York, NY; Makerere University Medical School (Drs Ziegler and Wabinga), and Uganda Cancer Institute (Dr Katangole-Mbidde), Kampala, Uganda; Chester Beatty Laboratories, London, England (Drs Boshoff, Schulz, Whitby, and Weiss); and the Division of HIV/AIDS, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Jaffe).

Footnotes
Members of the Uganda Kaposi's Sarcoma Study Group are listed at the end of the article.

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