Measuring inhalant nitrite exposure in gay men: implications for elucidating the etiology of AIDS-related Kaposi's sarcoma

We reviewed 12 epidemiologic studies conducted among gay men with AIDS to examine the role of potential 'cofactors' in the development of KS. Aspects of the studies reviewed include basic study design, wording of the questionnaires, and published results comparing KS patients with those who developed opportunistic infections indicative of AIDS. The studies included questions about sociodemographics, medical history, use of drugs, travel, and sexual behaviors. Patients were invited to provide blood and/or other specimens for laboratory analysis. The results of the review of epidemiologic studies are inconclusive. Nitrite inhalant use was a variable often associated with KS (five studies). The differences in outcomes of these studies may reflect differences in study designs, sample sizes, timing, quality, and content of interviews regarding nitrites, sexual behaviours and other potential cofactors. Epidemiologic study with careful consideration to content of questionnaires and laboratory testing may yet reveal the causes or cofactors for this tumor.