Jpn. J. Infect. Dis., 54, 2001

Laboratory and Epidemiology Communications

Seroprevalence or Human Herpesvims 8 in Okinawa, Japan
Masao Satoh*, Hiromu Toma. , Yoshiya Satol , Chotaku Futenma2, Susumu Kiyuna3,Yoshiyuki Shiroma3, Akatsuki Kokaze4, Shinsaku Sakurada5, Tetsutaro Sata6and Harutaka Katano6

Department of Medical Zoology, Saitama Medical School,
Mwohongo, Moroyama, Iruma‑gun, Saitama 350‑0495,
1Department ofParasitology, School of Medicine, University of the Ryub,u,Uehara 207, Nishihara, Okinawa 903‑0125,
2Minamidaito Clin ic,Zaisho 183‑1, Minamidaito, Shimajiri‑gun, Okinawa 901‑3805,3Izumizaki Hospital,Izumizaki 1‑ll‑2, Naha, Okinawa 900‑0021,

4Department of Public Health, Kyorin UniversitySchool of Medicine,

Shinkawa 6‑20‑2, Mitaka‑shi, Tobo 181‑8611,

5Bureau ofInternational Cooperation, International Medical Center of Japan,

Toyama 1‑21‑1, Shinjuku‑ku, Tob}0 162‑8655 and6Departmen i of Pathology, National Institute of Infectious Diseases,
Toyama 1‑23‑1, Shinjuku‑ku, To砂0 162‑8640

Communicated by Tetsutaro Sata

(Accepted July 27, 2001)

The hum.an herpesvirTs 8 ([HHV‑8], Kaposi's sarcoma

MinamidaitoJlma, a Smaller island which is about 300 kmlKS]‑assoclatFd herpesvlruS, lKSHV]) DNA sequence has
been demonstrated in all fbms of KS, which is the most

distant from Naha city. The ages (mean ± SD) were 49.8 ±9.01 (male) and 51.2士6.68 (female) in Naha city, and 55.6士

common malignant tumor among patients with acquired

14.9 (male) and 56.8士15.5 (female) in Minamidaitojima.

immunodeficiency syndrome (AIDS) ( 1 ,2). lt was also shown

Informed consent was obtained from all individuals. All sera

that the vinュs encoded several genes homologous to cellwere stored at ‑200C and heat inactivated at 56oC f♭r 30 min

cycle‑associated genes and cytokines, suggestlng that HHV‑
8 infection is necessary for the development of KS (3). The

befわre use. The presence of anti‑HHV‑8 antibodies wasdetermined by a mixed‑antlgen enZyme‑linked irrmunosorbent

geographic distribution of KS in the world is restricted toassay (using K8･ 1, ORF59, ORF65 and ORF73 proteins. ascertain regions (4,5), and this ge.ographic clustering could

mixed antigens) and indirect immunofluorescepce assay uslng

result丘om as‑yet‑undefined genetlC Or environmental factors.

acetone‑fixed TY‑ 1 cells (HHV‑8‑positive prlmary effusion

Although patients with KS are rare in Japan (6), some casesof KS have been observed in Okinawa, which is located in
the southem islands of Japan (7,8). Since Okinawa is anendemic area of human T‑cell leukemia virus type I (HTLV‑1), some KS cases in Okinawa have been associated withadult T cell leukemia/lymphoma or AIDS. However, cases ofthe classic type KS have been also reported from this area (7);lymphoma cell line) (9, 1 0). Fisher 's exact probability test wasused to analyze the significance of differences.
Only two positives were fわund in 140 individuals (1 ･43%)

in Nana city (Table 1). This positivity rate was almost thesame as that reported in the general Japanese population (9).
On the other hand, 1 3 positives were fわund in 404 individuals(3.22%) in Minamidaitojima (Table 2). This seropositivity

therefore, Okinawa is suspected to be one of the endemlC areasrate was fわund to be slightly higher than that of the generalor KS. The seropositivlty rate Of anti‑HHV‑8 antibodies in
the general Japanese population has been reported at 1.4%

Japanese population. This was due to an increased seropositiv‑

ityrate of males. Seropositivityof males in Minamidaitojima(9); however, the seroprevalence in Okinawa has not yet been

showed two peaks, one in the older groups (over 50 years old),

studied. In this study, to clarify the factors involved in theand the other in 30 to 40 years old. There were only 2 female

development of KS in Okinawa, the seropositivityrate ofanti‑
HHV‑8 antibodies was examined compared to the general
Table 1. Number ofHHV‑8 positive individuals in Naha city

Japanese population.
Tb study the distribution ofHHV‑8 ca汀iers in Okinawa,

HHV‑8 positives/Total illdividuals (%)

we examined the positivlty rate Of anti‑HHV‑8 antibody inMaleFemale

Totalthe semm. Sera were collected丘om a total of 140 individuals(98 males and 42 females) during health examinations in Nahacity, which is the central city of the main island ofOkinawa,
and a total of404 individuals (208 males and 1 96 females) in*Corresponding author: Tel: +8 1‑492‑76‑1 1 73, Fax: +8ト492194‑

2274, E‑mail: satoma@saitama‑ned.acjp

21‑30

0/1 (0.00)

0/0 (0.00)

0/I (0.00)

31‑40

0/17 (0.00)

0/3 (0.00)

0/20 (0.00)

4ト50

1/27 (3.70)

1/1 5 (6.67)

2/42 (4.76)

5 1 ‑60′0/42 (0.00)

0/21 (0.00)

0/63 (0.00)

61‑70

0/I 1 (0.00)

1/98 (1.02)

125

0/3 (0.00)

0/14 (0.00)

1/42 (2.38)

2/140 (1.43)

Jpn. J. Infect. Dis., 54, 2001
Table 2･ Number ofHHV‑8 positive individuals in Minamidaitojlma

patients with and without HIV infection. N. Engl. J. Med.,HHVl8 positivesrrotal individuals (%)

MaleFemale

0‑20

0/3 (0.00)

0/1 (0.00)

0/4 (0.00)

2ト30

0/6 (0.00)

0/6 (0.00)

0/12 (0.00)

31‑40

3/32 (9.38)

0/35 (0.00)

3/67 (4.48)

41‑50

1/34 (2.94)

0/25 (0.00)

I/59 (1.70)

5 1‑603/44 (6.87)

I/30 (3.33)

4/74 (5.41)

61‑70

2/53 (3.77)

1/65 (1.54)

3/118 (2.54)

71 ‑802/33 (6.06)

0/27 (0.00)

2/60 (3.33)

81+

0/3 (0,00)

0/7 (0.00)

0/10 (0.00)

l I/208 (5.29)*

2/196 (1.02)*

Total

332, 118ト1185.

3l Jaffe, H･ W･and Pellette, P. E. (1999): Human herpesviruS
8 and Kaposi's sarcoma. N. Engl. J. Med., 340, 1912‑

Total

1913.
4. Cottoni, F., De Marco, 良. and Montesu, M. A. (1996):

Classical Kaposi's sarcoma in north‑east Sardinia: anoverview from 1977 to 1991. Br. J. Cancer, 73, 1132‑1133.

5. Buchbinder, A. Q., H. Y., Cockerell, C. J. and Friedman‑
Kien, A. E. (1996): Clinical manifestations and histo‑
pathologic features of classic, endemic African, andepidemic AIDS‑associated Kaposi 's sarcoma. Jn Friedman‑

13/404 (3.22)*P< 0.05

Kien, A. E. and Cockerell, C. J. (eds), ColorAtlas ofAlDS.
2nd ed. W.良. Saunders, Co., Philadelphia.

6･ Fujii, Y., Takayasu, S., Yokoyama, S., Eizuru, Y.,

Minamishima, Y. and Enjoji, M. (1986): Kaposi'S sarcoma

seropositive individuals in the elders. The reason why thepositive rate of HHVl8 in Minamidaitojlma, especially inin a Korean living in Japan. ∫. Am. Acad. Demato1., 15,younger males, was higher than that in Naha clty and the76‑82.

general Japanese population is not clear. Because Minami‑

7. Kamada, Y, lwamasa, T., Miyazato, M., Sunagawa, K.

daitoJlma is a small island and far away from the main island

and Kunishima, N. (1992): Kaposi sarcoma in Okinawa.

of Okinawa, the population on this island is relatively isolated.

Cancer, 70, 861‑868.

Angeloni et al. ( I 1 ) reported the familial transmission ofHHV‑

8･ Kondo, Y., Izumi, T., Yanagawa, T., Kanda, H., Katano,8･ The two peaks of positive groups in males might support

H･ and Sata, T･ (2000): Spontqneously regressed Kaposi's

this possibility. However, because the age distribution in
Minamidaitqllma Was Older than that of the general Japanesesarcoma and human herpesvlruS 8 infection in a humanimmunode丘ciency virus‑negative patient. Pathol. Int. , 5 0,340‑346.

population (9), the differences in seropositivity rates could

9. Katano, H., Iwasaki, T., Baba, N., Terai, M., Mori, S.,

not be conclusively explained.

In conclusion, non‑slgnificant differences in the seroposi‑

Iwamoto, A., Kurata, T. and Sata, T. (2000): Identification

tivityrates of anti‑HHV‑8 antibodies were observed betweenof antlgenic proteins encoded by human herpesvirus 8

the Okinawa population and the general J叩aneSe populationand seroprevalence in the general population and amongin this study. Events in addition to HHV‑8 infection, such as

patients with and without Kaposi's sarcoma. J. Viro1.,

environmental factors, may be needed for the development

74, 3478‑3485.

of KS in Okinawa.

10･ Katano, H･ and Sata, T. (2000): Human herpesviruS 8‑virology, epidemiology and related diseases‑. Jpn. ∫.

Infect. Dis., 53, 1371155.

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