Kaposi's sarcoma (KS) and primary effusion lymphoma (PEL) cells are predominantly infected with latent Kaposi's sarcoma-associated herpesvirus (KSHV), presenting a barrier to the destruction of tumor cells. Latent KSHV can be reactivated to undergo lytic replication. Here we report that in PEL cells, oxidative stress induced by upregulated reactive oxygen species (ROS) can lead to KSHV reactivation or cell death. ROS are upregulated by NF-B inhibition and are required for subsequent KSHV reactivation. Disruption of the intracellular redox balance through depletion of the antioxidant glutathione or inhibition of the antioxidant enzyme catalase also induces KSHV reactivation, suggesting that hydrogen peroxide induces reactivation. In addition, p38 signaling is required for KSHV reactivation induced by ROS. Furthermore, treatment of PEL cells with a higher concentration of the NF-B inhibitor than that used for inducing KSHV reactivation further upregulates ROS and induces massive cell death. ROS, but not p38 signaling, are required for PEL cell death induced by NF-B inhibition as well as by glutathione depletion. Importantly, anticancer drugs, such as cisplatin and arsenic trioxide, also induce KSHV reactivation and PEL cell death in a ROS-dependent manner. Our study thus establishes a critical role for ROS and oxidative stress in the regulation of KSHV reactivation and PEL cell death. Disrupting the cellular redox balance may be a potential strategy for treating KSHVassociated lymphoma.Kaposi's sarcoma-associated herpesvirus (KSHV) is an oncogenic human DNA virus belonging to the gammaherpesvirus family. KSHV causes Kaposi's sarcoma (KS), primary effusion lymphoma (PEL), and a plasmablastic subtype of multicentric Castleman disease (MCD) (8,13,22). KSHV has two phases in its life cycle, i.e., latency and lytic replication. During lytic replication, most of the viral genes are expressed and new virions are produced to facilitate virus propagation and transmission. In contrast, only a few viral genes are expressed during latency (20, 57), enabling KSHV to evade immune surveillance and promoting virus persistence (3). KSHV persists in its latent form in the majority of KS and PEL tumors (21,53,77). Thus, latency presents a barrier to the elimination of KSHV and the treatment of KSHV-associated tumors.Therapeutic induction of virus reactivation provides an opportunity to target and eliminate KSHV-associated tumor cells (1,29,70). A key prerequisite to the success of this approach is to understand how cellular signals regulate KSHV reactivation in order for us to target specific cellular pathways to achieve efficient virus reactivation in tumor cells. KSHV replication and transcription activator (RTA) is the key viral regulator of virus reactivation (49, 61). RTA can activate the transcription of its target genes through direct binding to RTAresponsive elements (RRE) (59, 60) or by using cellular coregulators, such as CSL/RBP-J (44, 51), Oct-1 (55), C/EBP␣ (68), and AP1 (67). KSHV also encodes negative regulators of vi...