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March 27, 2002

Relationship Between Kaposi Sarcoma–Associated Herpesvirus and HIV

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(12):1525-1528. doi:10.1001/jama.287.12.1523

To the Editor: Dr Osmond and colleagues1 reported that KSHV infection was already highly prevalent among homosexual men in San Francisco when the HIV epidemic began, and that its prevalence did not change through 1996. On the other hand, the rapid increase in the incidence of HIV-associated Kaposi sarcoma (KS) in the early 1980s and its decline in the United States prior to the era of highly active antiretroviral therapy (HAART) suggests that KSHV alone does not cause KS. If KSHV infection does play an etiologic role in KS, then one would expect KS to "spread" to heterosexuals dually infected with HIV, which has not yet been observed. Furthermore, the decline in KS prior to HAART has not been explained.

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