Unfavorable controls were also included during both sample preparation and DNA extraction. tonsillar swabs from KS and non-KS patients. In KS patients, 14 out of 32 tonsillar swabs (43.7%), 11 out of 24 saliva samples (45.8%), and just 2 out of 24 urine samples (8.3%) tested positive for HHV-8 DNA. In the control group, on the contrary, none of the 20 saliva and 20 urine specimens was positive for HHV-8 DNA; only 1 1 out of 22 tonsillar swabs gave a positive result. This data supports the hypothesis that HHV-8 infects the general population in a latent form. The reactivation of viral contamination may result in salivary shedding of HHV-8, contributing to viral spread by nonsexual transmission routes. Kaposis sarcoma (KS) is usually a multifocal vascular tumor, with an uneven geographic distribution. Four types have been described: classic, iatrogenic, endemic, and AIDS-associated KS. The etiology of KS is still unknown. Recently, a new herpesvirus, named KS-associated herpesvirus or human herpesvirus 8 (HHV-8) (8, 18), has been recognized in virtually all KS lesions, from both human immunodeficiency computer virus (HIV)-seronegative and HIV-seropositive subjects, suggesting Tigecycline that this could be the infectious, sexually transmitted cofactor involved in KS pathogenesis (1, 5, 6, 9, 11, 14, 25). Molecular and epidemiological studies have suggested that HHV-8 could be common throughout the human populace, MTC1 especially in geographic areas where KS is usually prevalent (2, 7, 10, 21, 22). High rates of HHV-8 seroprevalence have recently been reported in Africa and Italy (13, 17). Interestingly, central and southern Italy are areas where a relatively high prevalence of classic KS has been observed (12, 20). Preliminary data suggests that rates of HHV-8 contamination could in fact be higher than previously believed (7, 29, 30). This supports the hypothesis that this prevalence of KS is usually correlated with the prevalence of HHV-8 contamination in a population. In order to evaluate the prevalence of HHV-8 contamination in the populations of central and southern Italy, serum samples from HIV-seronegative patients, with and without KS, were tested for anti-HHV-8 antibodies by indirect immunofluorescence assay (IFA). High HHV-8 seroprevalence rates, together with the detection of antibodies in young people in areas where KS is usually endemic (23, 26), suggest that multiple modes of transmission are possible; as for other herpesviruses, horizontal transmission, possibly via nongenital fluids, may in fact play an important role in the spread of HHV-8 (2, 3, 4, 10, 15, 17). In order to verify this hypothesis we tested for the presence of HHV-8 DNA in blood, saliva, tonsillar swabs, and urine from KS and non-KS patients. MATERIALS AND METHODS Patients and specimens. Fifty KS patients (mean age, 65.8 years) attending our Department of Dermatology were enrolled in the study. Thirty-nine of the patients (30 males and 9 females) were suffering from classic KS, and 11 were suffering from iatrogenic KS (8 males and 3 females). In all cases KS diagnosis was confirmed by routine histologic examination. Enzyme immunoassay and immunoblot analysis were used to Tigecycline screen all patients for antibodies to HIV types 1 and 2. Serum Tigecycline samples for antibody detection were obtained from each of the KS patients; 32 tonsillar swabs, 23 saliva specimens, and 24 urine specimens were also collected. A control group was created by including 70 patients Tigecycline affected by dermatological diseases other than KS and healthy subjects. All subjects came from the same geographic areas as the KS patients. Serum samples for antibody detection were collected from 50 subjects, 35 males and 15 females aged 30 to 87 years (mean age, 65.5 years). From 20 control subjects, 16 males and 4 females (mean age, 60.8 years), tonsillar swabs, saliva samples, and urine samples were collected and analyzed for HHV-8 DNA. Informed consent was obtained from all patients. IFA. An IFA was developed using the HHV-8-positive and Epstein-Barr computer virus (EBV)-unfavorable B-cell collection BC-3 (American Type Culture Collection, Manassas, Va.). The EBV producer cell collection P3HR-1 (American Type Culture Collection) and the HHV-8- and EBV-negative cell collection Ramos.