Suggests that the virus may be sexually transmitted. Can certainly be found in both semen and saliva. Viral gene products possibly implicated in pathogenesis include IL6 and CC chemokines, as well as a chemokine receptor. KSHV have pirated many genes from the eukaryotic genome, which then mutate quickly, to develop properties different to the cellular counterpart. Exactly the proportion who develop myeloma.
Infection persists for life with virus regularly shed by salivary gland.
Salivary fluid transmits the virus e.g. infected eating utensils and kissing. A link with Burkitt's lymphoma was first established when virus isolated from cultured Burkitt's cells, and linked to the disease sero-epidemiologically. EBV DNA can be isolated from tumours, viral specific antigens can be detected in the tumours, infection with EBV induces a lymphoma like disease in new world primates. In vitro EBV immortalization of B cells further supports the link. The mechanism by which the virus transforms cells is still uncertain.