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January 1997

Kaposi Sarcoma, Kaposi Sarcoma—Associated Herpesvirus, and Human T-Cell Lymphotropic Virus Type 1: What Is the Current Evidence for Causality?

Arch Dermatol. 1997;133(1):83-85. doi:10.1001/archderm.1997.03890370089013

KAPOSI SARCOMA (KS) has long fascinated epidemiologists, oncologists, and dermatologists. Its peculiar epidemiologic characteristics suggest an infectious cause and its mixed histogenesis and relatively indolent course in persons without human immunodeficiency virus (HIV) infection raise important questions about whether KS is a true cancer at all. This tumor's unique features led Oettle1 to propose in the early 1960s that KS may be caused by a virus. Extensive studies by Giraldo and colleagues2,3 on African-endemic and classic KS in the 1960s and 1970s suggest a herpesvirus, most probably cytomegalovirus, as the likely cause. Since then, a host of other agents, including most recently papillomaviruses,4 have been first proposed and then eliminated as candidate agents by careful laboratory studies.

Human T-cell lymphotropic virus type 1 (HTLV-1) belongs to the oncovirus subfamily of Retroviridae. In 1980, it was first isolated from a patient with an aggressive form of adult T-cell