Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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The San Francisco Examiner; April 2, 1998
Lisa M. Krieger, Examiner Medical Writer
About one out of three surveyed gay men in San Francisco is infected with the virus that causes the cancer called Kaposi's sarcoma, scientists have found.
The virus, herpes virus 8 (HHV8), is transmitted sexually and may be prevented through safe sex practices, according to a new study in the latest issue of the New England Journal of Medicine.
"The potential transmission of HHV8 through unprotected sexual practices provides yet another impetus to reinforce safe sexual behavior," wrote Jeffrey N. Martin and his team at UC-San Francisco.
There was no evidence of the virus in any of the heterosexual men studied, the study found.
Experts have suspected that HHV8 was the agent behind Kaposi's sarcoma. But they could not rule out the possibility that the infection was a result of the cancer and not the cause.
Risk of infection was found to increase with the number of years of gay sex, the number of gay partners, and past history of sexually transmitted disease, according to the survey of 800, half of them HIV-infected participants in the San Francisco Men's Health Study.
The finding solves a mystery that has puzzled researchers since 1994, when they discovered unusual genetic sequences in the cells of Kaposi's sarcoma-associated skin lesions.
But "our finding does not mean that HHV8 is only transmitted via homosexual sex," cautioned Dean Kedes, UCSF assistant research microbiologist and senior author of the study.
Transmission is sexual
"It does suggest that in the population that is most likely to develop KS, the major mode of transmission is sexual," he said.
An earlier Italian study found HHV8 in semen, not blood, relieving fears that the agent might be transmitted through transfusions.
This is the latest evidence to confirm the link between HHV8 and Kaposi's sarcoma, a mysterious cancer with blue-purple lesions that was unheard of in the United States until the late 1970s - around the same time as the
AIDS-causing human immunodeficiency virus.
Scientists now believe that two separate epidemics - HHV8 and HIV - coincided, causing deaths. HIV-induced immune system collapse, as well as other aspects of abundant unprotected gay sex, seems to boost the risk of developing the cancer.
The spread of HHV8 seems to have paralleled that of HIV - skyrocketing during the sexually libertine '80s and slowing in the '90s.
Kaposi's sarcoma has killed more than 50,000 HIV patients, but it causes few deaths among those who are not infected with HIV.
The new study predicts that HIV-positive men infected with the Kaposi's sarcoma virus have about a 50 percent chance of developing the cancer within a decade.
Immune system critical
It is believed that most infected people can live with the virus, without a trace of illness, as long as their immune systems are healthy.
The scientists believe that like other viruses, HHV8 may hide quietly for months or years, while the protective immune system keeps it at bay. This is the case in other viral infections, such as pneumonia and genital herpes.
Incidence of Kaposi's sarcoma is now on the decline in HIV-infected men because of safe sex practices. But some doctors fear that the agent may cause disease in infected men decades from now, as they age and their immune systems falter.
Other ongoing research suggests that HHV8 may cause more than just Kaposi's sarcoma. The virus also has been detected in patients with another form of cancer, a rare type of B-cell lymphoma.
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