According to the UNAIDS global report 2013, an estimated 6.1 million people are living with human immunodeficiency virus (HIV) in South Africa. The incidence of Kaposi sarcoma (KS) has increased dramatically since the Acquired Immunodeficiency Syndrome (AIDS) epidemic. Of the estimated 66 200 cases of KS worldwide, 58 800 are thought to have occurred in SSA (Parkin 2002). However, there remains a paucity of published data about KS from South Africa. This retrospective study was conducted to describe the epidemiology of KS at Chris Hani Baragwanath Academic Hospital (CHBAH) and to determine possible links among the CD4 counts, intensity and distribution of human herpes virus 8 latency- associated nuclear antigen 1 (HHV8 LNA-1) immunohistochemical staining and the stage of KS. Nine hundred and thirty eight histopathology reports of KS diagnosed in 901 patients at CHBAH between 2005 and 2009 were reviewed and demographic data (age, gender, topographic site, CD4 count, HIV status, KS stage, HHV8 LNA-1 staining, concomitant pathology) were recorded. The H&E stained sections and HHV8 LNA-1 immunostains of a cohort of 127 cases were subsequently reviewed and categorised with regard to intensity and distribution of staining. The male:female ratio was 1,2:1. The mean age was 36,8 years (standard deviation {SD} 10,2 years) and the median CD4 count 127,5 cells/mm3 (quartile range {QR} 184,5 cells/mm3). Lower limb skin biopsies accounted for 49,6% of cases. Concomitant pathology was seen in 4,6% of cases. Infections and inflammatory dermatoses were the most frequently diagnosed concomitant pathology in cutaneous biopsies. Paediatric, visceral and endemic KS accounted for only limited proportions of cases (1,44% of patients; 1,4% and 1,3% respectively). There was a significant difference in the distribution of HHV8 LNA-1 staining in patch versus nodular KS (p = 0,011). The CD4 counts were not predictive of KS Page | v stage (p = 0,701) or the intensity (p = 0,877) and distribution (p = 0,846) of HHV8 LNA-1 immunohistochemical staining. This study highlights the epidemiology of KS and the variability in HHV8 LNA-1 immunohistochemical staining across CD4 counts and stages of KS.

Thesis (Ph. D.)--Cornell University, January, 2007. / Vita. Includes bibliographical references (leaves 146-195).

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 163-232).

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 77-89).

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 84-104).

Thesis (Ph. D.)--University of Virginia, 2007. / Title from title page. Includes bibliographical references. Also available online through Digital Dissertations.

Xiao Wei. / Thesis submitted in: December 2002. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 95-109). / Abstracts in English and Chinese. / ABSTRACT --- p.i / ABSTRACT (CHINESE VERSION) --- p.iii / ACKNOWLEDGEMENTS --- p.v / TABLE OF CONTENTS --- p.vii / LIST OF TABLES --- p.ix / LIST OF FIGURES --- p.x / LIST OF ABBREVIATIONS --- p.xii / Chapter Chapter One --- Introduction --- p.1 / Chapter 1.1 --- Discovery of HHV8 --- p.2 / Chapter 1.2 --- Biology of HHV8 --- p.3 / Chapter 1.2.1 --- Morphology --- p.3 / Chapter 1.2.2 --- Classification --- p.3 / Chapter 1.2.3 --- Cell culture --- p.4 / Chapter 1.2.4 --- Latent and lytic life cycle --- p.4 / Chapter 1.2.5 --- Genome organisation --- p.5 / Chapter 1.2.6 --- Strain variability --- p.6 / Chapter 1.3 --- Disease association of HHV8 --- p.8 / Chapter 1.3.1 --- Kaposi's sarcoma --- p.8 / Chapter 1.3.2 --- Other associated diseases --- p.10 / Chapter 1.4 --- Tropism of HHV8 --- p.11 / Chapter 1.5 --- Epidemiology of HHV8 --- p.13 / Chapter 1.5.1 --- Geographic distribution --- p.13 / Chapter 1.5.2 --- Age distribution --- p.15 / Chapter 1.5.3 --- HIV-infected individuals without Kaposi's sarcoma --- p.16 / Chapter 1.5.4 --- Bone marrow transplant and blood transfusion recipients --- p.19 / Chapter 1.5.5 --- Sexually transmitted disease clinic attendees --- p.18 / Chapter 1.5.6 --- HIV-negative intravenous drug users --- p.19 / Chapter 1.6 --- Transmission of HHV8 --- p.20 / Chapter 1.7 --- Methods for HHV8 antibody detection --- p.23 / Chapter 1.7.1 --- Antibodies against latent antigens --- p.23 / Chapter 1.7.2 --- Antibodies against lytic antigens --- p.24 / Chapter 1.7.3 --- Comparison between assays --- p.25 / Chapter 1.8 --- Project design --- p.26 / Chapter Chapter Two --- Methods and Materials --- p.29 / Chapter 2.1 --- Study I. Seroprevalence of HHV8 in Hong Kong --- p.30 / Chapter 2.1.1 --- Study population --- p.30 / Chapter 2.1.2 --- Source of HHV8 antigens --- p.32 / Chapter 2.1.3 --- Positive and negative controls --- p.34 / Chapter 2.1.4 --- Procedures for immunofluorescence assay --- p.34 / Chapter 2.1.5 --- Statistical methods --- p.36 / Chapter 2.2 --- Study II. Prevalence of HHV8 DNA in cervical scrapes --- p.36 / Chapter 2.2.1 --- Study population --- p.36 / Chapter 2.2.2 --- Preparation of cell lysate --- p.38 / Chapter 2.2.3 --- PCR amplification for human beta-actin gene --- p.38 / Chapter 2.2.4 --- PCR for HHV8 DNA --- p.41 / Chapter 2.2.5 --- Statistical methods --- p.45 / Chapter 2.3 --- Study III. HHV8 ORF 26 nucleotide sequence determination --- p.45 / Chapter 2.3.1 --- Study samples --- p.45 / Chapter 2.3.2 --- Sequencing method --- p.46 / Chapter 2.3.3 --- Nucleotide sequence data analysis --- p.49 / Chapter Chapter Three --- Result --- p.51 / Chapter 3.1 --- Study I. Seroprevalence of HHV8 in Hong Kong populations --- p.52 / Chapter 3.1.1 --- Seroprevalence of HHV8 in reference group --- p.52 / Chapter 3.1.2 --- HIV-negative intravenous drug users --- p.55 / Chapter 3.1.3 --- HIV-positive individuals without Kaposi's sarcoma --- p.57 / Chapter 3.1.4 --- Transfusion-dependent patients --- p.59 / Chapter 3.2 --- Study II. Prevalence of HHV8 DNA in cervical samples --- p.61 / Chapter 3.2.1 --- Optimisation of beta-actin PCR --- p.61 / Chapter 3.2.2 --- Optimisation of HHV8 ORF 26 PCR --- p.61 / Chapter 3.2.3 --- Analytical sensitivity of HHV8 nested PCR --- p.67 / Chapter 3.2.4 --- General female population --- p.67 / Chapter 3.2.5 --- Sexually transmitted disease clinic attendees --- p.73 / Chapter 3.3 --- Study III. Sequence variation of HHV8 ORF 26 fragment --- p.76 / Chapter Chapter Four --- Discussion --- p.84 / Chapter 4.1 --- Study I. Seroprevalence of HHV8 in Hong Kong populations --- p.85 / Chapter 4.1.1 --- Distribution of HHV8 in reference group --- p.86 / Chapter 4.1.2 --- HIV-positive individuals without Kaposi's sarcoma --- p.87 / Chapter 4.1.3 --- HIV-negative intravenous drug users --- p.88 / Chapter 4.1.4 --- Transfusion dependent patients --- p.88 / Chapter 4.2 --- Study II. Prevalence of HHV8 DNA in cervical samples --- p.89 / Chapter 4.2.1 --- General female population --- p.90 / Chapter 4.2.2 --- Sexual transmitted disease clinic attendees --- p.90 / Chapter 4.3 --- Study III. HHV8 ORF 26 nucleotide sequence variation --- p.91 / Chapter 4.3.1 --- Sequence variability --- p.91 / Chapter 4.3.2 --- HHV8 ORF26 genotyping --- p.91 / Chapter 4.3.3 --- Comparison with HHV8 isolates from other populations --- p.92 / Chapter 4.4 --- Conclusions --- p.93 / REFERENCES --- p.95

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 3 uppsatser.

Thesis (Ph. D)--University of Washington, 1999. / Includes bibliographical references (leaves 364-392).

Thesis (Ph. D.)--Cornell University, May, 2008. / Vita. Includes bibliographical references (leaves 127-162)