Significance of Oral KS in an African Setting

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DESCRIPTION (provided by applicant): Kaposi's sarcoma (KS) tumors are a common disease manifestation when KS occurs in persons with the acquirred immunodeficiency syndorme (AIDS-KS) in Zimbabwe and other African settings. Despite the commoness of oral KS in African AIDS patients, little is known about the clinical and virological correlates of oral KS in this setting. Since AIDS-KS is currently the most frequent malignancy in many areas of Africa, it is important to better understand the significance of oral KS disease in African AIDS patients. The studies proposed in the present application are collaboration between investigators at the University of Colorado Health Sciences Center and the University of Zimbabwe Medical School. The proposed studies will investigate the hypothesis that important immunologic and virologic differences exist between Africans who have oral KS lesions as a manifestation of AIDS-KS, compared to Africans with AIDS-KS without oral KS disease. The specific aims of the proposed studies are: 1. To establish a repository of KS tissue, plasma, peripheral blood mononuclear cells and saliva from persons with oral KS for use in studies of the pathogenesis of oral KS in Africa. 2. To determine if there is an association between CD4+ lymphocyte count or plasma HIV-1 RNA and the presence of oral KS in Africans with AIDS-KS. 3. To compare the patterns of HHV-8 gene expression in oral and cutaneous KS lesions. 4. To evaluate potential associations between oral KS lesions and HHV-8 subtypes that are prevalent in Africa. That oral KS is a marker increased risk of disease progression in Africans with AIDS-KS. It is expected that the results of these studies will provide useful information to programs for introduction of contemporary antiretroviral treatment in resource-limited areas of Africa.