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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 noted the lack of consensus as to the route of KSHV transmission in homosexual men. Recent studies1-3 have suggested that KSHV, also known as human herpesvirus 8 (HHV-8), is primarily transmitted among homosexual men through deep kissing or oral sex. While this hypothesis is consistent with much of the data, it fails to explain why HHV-8 is much more prevalent in homosexual than in heterosexual men, since deep kissing and oral sex are common in both groups. Nor can differences in HHV-8 prevalence be solely attributed to numbers of sex partners, because even commercial sex workers have a lower prevalence of HHV-8 than do homosexual men.4 Thus, the higher prevalence of HHV-8 among homosexual men may be related to sexual practices, such as anal sex, that are more prevalent among this population. Several findings of Osmond et al are consistent with this hypothesis.