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Kaposi Sarcoma-Associated Herpesvirus and Primary and Secondary Pulmonary Hypertension^*

^* From the University of Pittsburgh Graduate School of Public Health (Mr. Laney and Mr. Peters), Pittsburgh, PA; University of California, San Francisco Cardiovascular Research Institute (Drs. De Marco and Malloy, and Ms. Teehankee), San Francisco, CA; and the Molecular Virology Program (Drs. Moore and Chang), University of Pittsburgh Cancer Institute, Hillman Cancer Center, Pittsburgh, PA.

Correspondence to: Yuan Chang, MD, Molecular Virology Program, University of Pittsburgh Cancer Institute, Hillman Cancer Research Pavilion, Suite #1.8, 5117 Centre Ave, Pittsburgh, PA 15213; e-mail: yc70{at}pitt.edu

Background: Kaposi sarcoma-associated herpesvirus (KSHV) has been implicated as a factor in the pathogenesis of primary pulmonary hypertension (PPH). We conducted a case-control study of patients with PPH and pulmonary hypertension (PH) associated with other disorders (secondary PH) to look for evidence of KSHV infection.

Materials and methods: The study population was composed of patients with a diagnosis of PH at the University of California San Francisco Medical Center Department of Cardiology between July and November 2003. Serologic testing for KSHV was performed using enzyme-linked immunosorbent assays based on peptides from open reading frame-65 and K8.1, using sera from 19 patients with PPH, 29 patients with secondary PH, and 150 control subjects

Results: The overall seroprevalence of KSHV among all study participants was 2.0%. The rate among control subjects was 0.7% (1 of 150 subjects); among the study participants with PPH, we found no evidence of KSHV infection (0 of 19 patients). There was no significant difference between the observed seroprevalence of KSHV among patients with PPH compared to control subjects (p = 0.89). Of the 29 patients with a diagnosis of secondary PH, 3 patients (10.3%) were KSHV seropositive. Significantly, two of the three KSHV-infected secondary PH patients were also HIV positive, a known independent risk factor for KSHV infection and secondary PH.

Conclusion: Our data do not support KSHV infection having a significant role in PPH or non-HIV-associated secondary PH compared to age- and gender-matched control subjects.

Key Words: enzyme-linked immunosorbent assay • human herpesvirus-8 • K8.1 • Kaposi sarcoma-associated herpesvirus • open reading frame-65 • pulmonary hypertension

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