Relationship of Kaposi sarcoma (KS)-associated herpesvirus viremia and KS disease in Zimbabwe

The relationship between Kaposi sarcoma-associated herpesvirus ( KSHV) viremia and KS disease was investigated in 500 subjects who received treatment in Harare, Zimbabwe. Subjects were grouped by results of human immunodeficiency virus (HIV) type 1 serological tests, KS diagnosis, and KS clinical stage. The plasma KSHV DNA concentration was associated with concomitant KS and HIV-1 infection (AIDS-KS;) and P < .001 AIDS-KS clinical stage (P = .01). Plasma KSHV DNA levels were greater in AIDS-KS than in matched HIV-1-seronegative (P = .01). The plasma KSHV DNA level was not associated with age, sex, systemic symptoms, or CD4(+) lymphocyte count. Plasma and peripheral blood mononuclear cell KSHV DNA concentrations were linearly related (r(2) = .44; P < .001), and the nucleotide sequence of the K1 gene highly variable region was identical in both compartments. These findings provide evidence that KSHV viremia is common in advanced AIDS-KS in Zimbabwe and suggest a relationship between KSHV lytic replication and untreated HIV-1 infection.