Blood, Vol. 91 No. 2 (January 15), 1998:
pp. 724-724
CORRESPONDENCE
Seroprevalence of Kaposi's Sarcoma-Associated Herpes
Virus Antibody in Young Adult Hodgkin's Disease
 |
LETTER |
To the Editor:
Epidemiologic evidence strongly suggests that young adult Hodgkin's
disease (YAHD) is a rare sequelum of a late (adolescence or young
adulthood) infection with a common childhood virus, analogous to the
appearance of paralysis after natural infection with
poliovirus.1 Although Epstein-Barr virus (EBV) is
considered the leading candidate as the putative causal virus, current
evidence is inconclusive. EBV DNA has been demonstrated in Hodgkin's
tumors, but is much less prevalent in tumors from young adult cases or
cases of the nodular sclerosis type.2 If EBV does play an
etiologic role, there is likely to be a cofactor, possibly another
virus.
KSHV (Kaposi's Sarcoma Associated Herpes Virus or Human Herpes Virus
8), like EBV, is a gamma Herpes virus, with sequence homology to EBV.
It was first isolated from Kaposi's sarcoma tumor tissue3
and subsequently from tumor tissue and peripheral blood mononuclear
cells from patients with body cavity lymphomas,4 Castleman's disease,4 and multiple myeloma (in bone marrow stromal cells only).5 Ninety percent of Kaposi's sarcoma
patients and 11% of human immunodeficiency virus-negative adult blood
donors are positive for KSVH antibody.6 Although a few
cases of Hodgkin's disease have been evaluated for evidence of this
virus (with negative results), neither age at diagnosis nor histologic
type was specified.4,5
We examined serum from 39 twin pairs with Hodgkin's disease diagnosed
before age 50, plus 46 controls, to assess the seroprevalence of KSHV
antibody in YAHD patients. Subjects were recruited from the
International Twin Study, a large registry developed by advertising for
twins with chronic disease. Three twin pairs were concordant for YAHD
and 36 were discordant, totaling 42 YAHD cases (60% nodular sclerosis,
12% mixed cellularity, 5% lymphocyte predominant, 2% lymphocyte
depleted, 7% not otherwise specified, and 14% unknown histology).
Thirty-six healthy twins of cases were also tested. Controls comprised
spouses or friends of either member of the twin pair (38), two healthy
identical twin pairs (4), and laboratory staff (2). Forty-six percent
of the twin pairs were male and 54% were female; 48% of controls were
male and 52% were female. Laboratory investigators were blinded with
respect to the identity of the case, cotwin, and control.
KSHV-IgG antibody was measured from thawed frozen serum using whole
viral lysate containing the majority of the KSHV structural proteins in
an enzyme-linked immunosorbent assay. Serum from 92 Kaposi's sarcoma
patients gathered in a population-based case-control study were
analyzed simultaneously as an internal control for the assay. One YAHD
case and one control were each positive for KSVH antibody, at the
lowest detectable concentration (0.05 to 0.20), giving a prevalence in
cases and controls of 2%. Both the case and the control were male.
None of the 36 healthy twins of YAHD cases was positive. In contrast,
40 of the 92 KS sera were positive for KSVH antibody (44%).
KSHV antibody was not detectable in any substantial number of YAHD
cases. Thus, it appears that KSHV does not play a role in the etiology
of YAHD, and the search to identify the etiologic agent of YAHD must
continue.
Wendy Cozen
Department
of Preventive Medicine
Rizwan Masood
Thomas Mack
Department of Pathology
Parkash S. Gill
Department of Medicine
University of Southern California
School of Medicine
Los Angeles, CA
Dharam V. Ablashi
Advanced Biotechnology, Inc.
Columbia, MD
| |
ACKNOWLEDGMENT |
Support for this project was provided by National Institutes of Health
Grants No. CA58839 and UO1 CA66533.
| |
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