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11 Jan 2002

high rates of kaposi's-associated virus likely spread during oral sex

A new study suggests that the virus that causes Kaposi's sarcoma, the cancerous skin lesions commonly associated with HIV/AIDS, may be primarily transmitted through unprotected oral sex, and not unprotected anal intercourse as first thought.

The incidence of Kaposi's sarcoma-associated herpesvirus (KSHV) among gay men has not significantly changed since the AIDS epidemic began. In fact, rates remained consistent even during periods when unsafe anal sex and HIV declined.

Kaposi's sarcoma as seen on the arm of a patient. Thirty percent of AIDS patients have Kaposi's sarcoma.
Researchers from the University of California, San Francisco analysed participants from numerous San Francisco based studies including the San Francisco Men's Health Study and the Young Men's Health Study (YMHS).

Despite decreasing rates of HIV infection between 1984 and 1985, men continued to get infected with KSHV at consistently high rates, hovering between 25 and 30 percent of the sample populations analysed.

Kaposi's sarcoma (KS) is a rare form of cancer that is strongly associated with AIDS. KSHV was prevalent among gay men prior to the AIDS epidemic.

Of a small random sample taken between 1978 and 1979, prevalence of KSHV infection was 26.5 percent. When another sample was analysed between 1984/85 the rate was 29.6 percent, and in a 1995/96 there was a 26.4 percent rate of KSHV infection. Meanwhile HIV prevalence dropped from almost 50 percent of a sample of 825 men in 1984/85 to 17.6 percent of 428 men in 1992/93.

During the period between 1984 and 1993 the number of men having unprotected sex with one or more partner decreased significantly from 54 percent to 11 percent. Yet the rates of KSHV continued to mount.

"We think the data strongly suggest that avoiding unprotected anal intercourse is not enough to avoid acquiring this viral infection," the study's lead author, Dr. Dennis H. Osmond, told Reuters Health. People can transmit KSHV during oral sex, and rates of oral sex remained high throughout the study periods.

Findings were published in the Journal of the American Medical Association (JAMA).

More about Kaposi's Sarcoma (KS)

What are the signs of KS?
People with KS usually develop raised, often painless lesions that can develop any place on the body. Frequently, KS lesions appear first on the tip of the nose or the soles of the feet. These lesions appear reddish-purple in light skinned people and bluish or brownish-black in dark skinned people. KS in the mouth can cause trouble with eating and swallowing . KS in the gastro-intestinal area (stomach or gut) can cause abdominal pain and gastro-intestinal bleeding. If KS shows up in a person's lungs, they might develop a serious cough or have shortness of breath. KS can also cause painful edema (swelling) in the legs.

Who Gets KS?
HIV-related KS is unusual in that it develops mainly (90 percent or more) in gay and bisexual men. The small minority of women with KS are thought to have acquired it through sex with gay or bisexual men. However, although HIV-related KS is rare in women, if you are female and think you might have KS, you should see your doctor right away.

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