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To evaluate the human herpesvirus 8 (HHV-8) DNA load in peripheral blood mononuclear cells (PBMC) and Kaposi's sarcoma (KS) skin lesions of subjects with AIDS and to correlate these measures with the tumour load.Assessment of the HHV-8 DNA load was performed every 3 months in PBMC and every 6 months in KS skin lesions from seven subjects with AIDS who were receiving highly active antiretroviral therapy (HAART).The HHV-8 DNA load was determined by a quantitative-competitive PCR using 0.2 μg of DNA from PBMC or KS skin biopsies. Staging of KS was performed by evaluating the number and type of cutaneous KS lesions.The three subjects with the most extensive and active (nodular) KS had the highest amounts of HHV-8 DNA in KS skin lesions and the lowest CD4 T cell counts (< 200 × 106/l). In contrast, the four other subjects with regressing KS while on HAART had a low viral load in their KS lesions. All but one subject who also had multicentric Castleman's disease had low amounts of HHV-8 DNA in PBMC.There is a strong relationship between the tumour burden and the HHV-8 viral load in KS skin lesions of subjects with AIDS, reinforcing the causal link between this herpesvirus and AIDS-related KS.