Timing of Human Immunodeficiency Virus Type 1 and Human Herpesvirus 8 Infections and Length of the Kaposi's Sarcoma–Free Period in Coinfected Persons
Year: 2001
Type: letter
Abstract: To the Editor—In 1998, we reported that human immunodeficiency virus type 1 (HIV-1)–infected homosexual men have the highest risk of developing Kaposi’s sarcoma (KS) if they acquire human herpesvirus 8 (HHV-8) after HIV infection [1]. This observation has been confirmed recently by Jacobson et al. [2], who also found that the duration of HIV-1 infection before HHV-8 acquisition influences the risk for KS. Therefore, we [1] and Jacobson et al. [2] suggested that immunodeficiency at the time of primary HHV-8 infection may shorten the KS-free period In a subsequent correspondence, Rezza [3] suggested that this is not necessarily the case, since most cases of transplant-associated KS in an HHV-8–endemic country occurred in patients who had acquired HHV-8 before transplantation [4]. Rezza infers from these data that factors like HIV-1 Tat and/or inflammatory cytokines, rather than immunosuppression, might be responsible for the increased incidence of KS in HIV-1 and HHV-8 coinfected persons Jacobson and Jenkins [5] responded to the report by Rezza [3] by suggesting that KS in HIV-1–negative transplant recipients cannot be formally compared with KS in HIV-1–positive individuals in regard to the impact of immunosuppression on the rate of progression of HHV-8 infection to KS. We agree with the comments of Jacobson and Jenkins and wish to point out that, in our original report [1], CD4 cell count, not HIV-1 virus load, was an independent risk factor for KS. In our view, it is therefore more likely that HIV-related immunodeficiency, rather than steady-state levels of HIV in blood, and, by inference, levels of HIV-1 Tat or inflammatory cytokines increase the risk for KS
DOI: 10.1086/319875
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2167156294