Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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San Francisco Examiner - January 9, 2002
Tanya Pampalone, Of The Examiner Staff
The data come from a study by University of California, San Francisco researchers, who found that one in four gay men in San Francisco had the virus that causes Kaposi's sarcoma (KS) in 1978 -- years before the onset of the HIV epidemic, which means KS contraction is independent of HIV infection.
"There was an assumption that they came along at the same time, and this study separates them," said Jeff Sheehy,
The study, published today in the Journal of the American Medical Association, examined serum stored from three earlier studies of gay men in San Francisco.
By examining the serum, researchers found that levels of the KS causing herpesvirus -- called Kaposi's sarcoma-associated herpesvirus (KSHV) -- remained steady between 1978 and 1996, while the HIV rates have both spiked and declined.
The researchers also found that the herpesvirus transmission in gay men is more likely transmitted through oral sex than through anal intercourse, as previously thought.
Between 1984 and 1995, the researchers found a significant decrease in the practice of unprotected anal intercourse, which they say explains the decline of HIV transmission.
But the prevalence of the herpesvirus infection did not change, suggesting that oral intercourse is a more likely route of the KS virus transmission than anal intercourse. This finding could alter prevention behaviors, which tend to focus on anal intercourse to prevent HIV.
People can live with the KS virus and won't develop Karposi's sarcoma, unless their immune system is damaged, as in the case with HIV. While the virus is found in the general population, it is much more commonly found among gay men. But researchers don't yet know why.
The testing samples from gay men in San Francisco in 1978-80 showed 24.9 percent infected with the herpesvirus (KSHS) and only 1.8 percent with HIV. With specimens drawn from 1984-85, HIV rates skyrocketed to 50 percent while herpesvirus infection was steady at 29.6 percent. The final study from 1995-96 showed HIV infection dropped to 18 percent and KSHV was at 26.4 percent.
While Karposi's sarcoma -- which are skin lesions and internal lesions which can be fatal -- was seen in certain populations before AIDS, it became a prominent AIDS diagnosis when the disease reached epidemic levels, according to the study's lead author, UCSF researcher Dennis H. Osmond.
But cases of Karposi's sarcoma in AIDS patients are seen much less often since the introduction of highly active antiretroviral therapy (HAART), Ormond said.
"Karposi's sarcoma didn't go away because the (KS virus) went away , because the virus is still there," he said.
E-mail Tanya Pampalone at tpampalone@sfexaminer.com
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