Kaposi's sarcoma-associated herpesvirus (KSHV) infection is a prerequisite for the development of Kaposi's sarcoma (KS).Kaposi's sarcoma (KS) is a multifocal malignant tumor of endothelial cell origin characterized by the proliferation of spindle-shaped cells with aberrant neovascularization and a large inflammatory cell infiltrate (14). KS usually manifests as pigmented nodular skin lesions, but can often spread to visceral organs in immunocompromised hosts, including AIDS patients (18, 34) and organ transplant recipients (15,46,54). This aggressive and disseminated form of KS was recognized as one of the first AIDS-defining conditions at the beginning of the human immunodeficiency virus (HIV) epidemic in the early 1980s (1, 29). Without effective therapy, visceral KS can be highly fatal unless the underlying causes of immune suppression are successfully treated (13, 21). Cytotoxic chemotherapeutic agents are commonly used in disseminated KS with response rates of up to 80% (22, 59). However, the majority of these agents are associated with serious side effects, and the tumor response to any chemotherapeutic regimen is only transient. There is no definitive cure for KS at the present time.KS-associated herpesvirus (KSHV, also called human herpesvirus 8) was first discovered in KS lesions obtained from patients with AIDS (9). It was subsequently found in all forms of KS and has strongly been implicated in the pathogenesis of KS (41). KSHV is a gamma-2 herpesvirus (genus Rhadinovirus) closely related to other oncogenic gammaherpesviruses, including herpesvirus saimiri (gamma-2), murine gammaherpesvirus (gamma-2), and Epstein-Barr virus (EBV) (gamma-1) (42). Since its discovery, KSHV has also been linked to a rare form of AIDSassociated effusion-based B-cell lymphoma, termed primary effusion lymphoma or body cavity-based lymphoma (BCBL) (8), and a subset of multicentric Castleman's disease (56).Although the exact etiologic mechanism of these neoplastic disorders is still unclear, KSHV infection is believed to play a critical role in the tumorigenesis and/or tumor progression. A number of studies have shown that higher levels of KSHV viral load in peripheral blood mononuclear cells and/or serum antibody titers against KSHV proteins correlated with increased risk of KS in HIV-infected (49, 60) and uninfected individuals (16,44). Higher KSHV viral load in peripheral blood has also been associated with progressive KS in HIV-infected individuals (6, 45). Moreover, several clinical studies, including one prospective study, have found that the risk of KS was significantly reduced in AIDS patients who received ganciclovir