Risk factors for Kaposi's sarcoma among HHV‐8 seropositive homosexual men with AIDS

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Abstract
Kaposi's sarcoma (KS) is a frequent complication of the acquired immunodeficiency syndrome (AIDS) in homosexual men. Risk factors for developing this malignancy are uncertain, other than immunosuppression and coinfection with human herpesvirus 8 (HHV‐8). We therefore examined factors associated with KS in a cross‐sectional analysis of 99 cases among 503 HHV‐8 seropositive homosexual men with AIDS. Data were collected by computer‐assisted personal interviews and medical chart reviews. HHV‐8 seroreactivity was determined by enzyme‐linked immunosorbent assay for antibodies against HHV‐8 K8.1 glycoprotein. KS was significantly less common in blacks compared to whites [risk ratio (RR) = 0.4; 95% CI = 0.2 =0.8] and more common in subjects who had completed college (RR = 1.7; 95% CI = 1.1–2.7) or had annual income greater than $30,000 (RR = 1.5; 95% CI = 1.1–2.2). KS was less common in cigarette smokers (RR = 0.6; 95% CI = 0.5–0.9) and users of crack cocaine (RR = 0.4; 95% CI = 0.1–0.8). KS was less common in bisexual men compared to men who were exclusively homosexual (estimated RR = 0.6; 95% CI = 0.4–0.9) and inversely associated with number of female partners. KS was also less common in men who had received pay for sex (RR = 0.6; 95% CI = 0.4–1.0). These cross‐sectional associations could be biased by potential differences in relative timing of HHV‐8 and HIV infection, a postulated determinant of KS risk. Alternatively, our findings may reflect factors protective against KS in individuals infected with HHV‐8. Future research should focus on identifying practical measures for countering KS that do not increase the risk of other diseases. Published 2005 Wiley‐Liss, Inc.

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