CiteWeb id: 20090000251

CiteWeb score: 2736

DOI: 10.1056/NEJM199505043321802

Background. DNA fragments that appeared to belong to an unidentified human herpesvirus were re- cently found in more than 90 percent of Kaposi's sarcoma lesions associated with the acquired immunodeficiency syndrome (AIDS). These fragments were also found in 6 of 39 tissue samples without Kaposi's sarcoma, includ- ing 3 malignant lymphomas, from patients with AIDS, but not in samples from patients without AIDS. Methods. We examined the DNA of 193 lymphomas from 42 patients with AIDS and 151 patients who did not have AIDS. We searched the DNA for sequences of Ka- posi's sarcoma-associated herpesvirus (KSHV) by South- ern blot hybridization, the polymerase chain reaction (PCR), or both. The PCR products in the positive samples were sequenced and compared with the KSHV sequences in Kaposi's sarcoma tissues from patients with AIDS. Results. KSHV sequences were identified in eight lymphomas in patients infected with the human immuno- deficiency virus. All eight, and only these eight, were body-cavity-based lymphomas — that is, they were char- acterized by pleural, pericardial, or peritoneal lymphoma- tous effusions. All eight lymphomas also contained the Epstein-Barr viral genome. KSHV sequences were not found in the other 185 lymphomas. KSHV sequences were 40 to 80 times more abundant in the body-cavity- based lymphomas than in the Kaposi's sarcoma lesions. A high degree of conservation of KSHV sequences in Ka- posi's sarcoma and in the eight lymphomas suggests the presence of the same agent in both lesions. Conclusions. The recently discovered KSHV DNA se- quences occur in an unusual subgroup of AIDS-related B-cell lymphomas, but not in any other lymphoid neo- plasm studied thus far. Our finding strongly suggests that a novel herpesvirus has a pathogenic role in AIDS-related body-cavity-based lymphomas. (N Engl J Med 1995;332: 1186-91.) N patients with the acquired immunodeficiency syn- drome (AIDS) there is a probability of approxi- mately 40 percent that cancer will develop, especially Kaposi's sarcoma and non-Hodgkin's lymphoma. 1-4 Chang et al. 5 recently found evidence suggesting an in- fectious cause of Kaposi's sarcoma, an observation con- sistent with those in previous epidemiologic studies. 1,6-11 Two novel DNA fragments were isolated from the Ka- posi's sarcoma lesions of patients with AIDS and iden- tified in more than 90 percent of such lesions, but they were not found in DNA samples from patients without AIDS. These fragments were also identified in 6 of 39 tissues without Kaposi's sarcoma from patients with AIDS, including 3 malignant lymphomas. The base se- quence of the DNA fragments and their flanking se- quences had partial homology to two herpesviruses, Epstein-Barr virus (EBV) and herpesvirus saimiri, both of which belong to the subfamily of Gammaherpesviri- nae. 5 These data suggested the presence in AIDS-asso- ciated Kaposi's sarcoma of a previously unidentified human herpesvirus, which we refer to as Kaposi's sar- coma-associated herpesvirus (KSHV). Most AIDS-related non-Hodgkin's lymphomas are diffuse B-cell lymphomas of the following types: small- noncleaved-cell (Burkitt's and non-Burkitt's) lympho- mas (40 percent), large-cell lymphomas (30 percent), and large-cell, immunoblastic plasmacytoid lympho- mas (30 percent). 12 Among the less common types found in patients infected with the human immunode- ficiency virus (HIV) 13 are the body-cavity-based lym- phomas. These may constitute a distinct subgroup be- cause of their unusual clinical, immunophenotypic, and molecular genetic characteristics. 14-17 They grow exclu- sively or mainly in the pleural, pericardial, and perito- neal cavities as lymphomatous effusions, usually with no identifiable tumor mass throughout their clinical course. They have indeterminate immunophenotypes but B-cell genotypes with clonal rearrangements of the immunoglobulin genes. Furthermore, unlike many AIDS-related B-cell non-Hodgkin's lymphomas, 18,19 the body-cavity-based lymphomas that were previously

The publication "KAPOSI'S SARCOMA-ASSOCIATED HERPESVIRUS-LIKE DNA SEQUENCES IN AIDS-RELATED BODY-CAVITY-BASED LYMPHOMAS" is placed in the Top 10000 of the best publications in CiteWeb. Also in the category Biology it is included to the Top 10000. Additionally, the publicaiton "KAPOSI'S SARCOMA-ASSOCIATED HERPESVIRUS-LIKE DNA SEQUENCES IN AIDS-RELATED BODY-CAVITY-BASED LYMPHOMAS" is placed in the Top 1000 among other scientific works published in 2009.
Links to full text of the publication: