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Andrade-Carmona VR, Carmona-Araiza LG, Soria-Cespedes D, Gómez-Virgilio L, López-Toledo G. Kaposi Sarcoma Mimicking a Lingual Lesion in an HIV-Negative Patient: A Case Report. Cureus 2024; 16:e57131. [PMID: 38681393 PMCID: PMC11055566 DOI: 10.7759/cureus.57131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
Tonsillar Kaposi sarcoma is rare, reported in patients with human immunodeficiency virus (HIV) infection. This case report of a tonsillar Kaposi sarcoma (KS) in an HIV-negative male patient, initially misinterpreted as a lingual lesion diagnosed with KS following tonsillectomy, highlights the value of a differential diagnosis in atypical presentations. The case report discusses the etiologic agent of KS, its detection and treatment, and a few case reports about tonsillar KS with no association with AIDS. The case underscores the diagnostic challenge of oropharyngeal lesions, particularly in patients with risk factors but negative HIV status.
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Seroprevalence and risk factors for Kaposi's Sarcoma associated herpesvirus among men who have sex with men in Shanghai, China. BMC Infect Dis 2023; 23:59. [PMID: 36721125 PMCID: PMC9887846 DOI: 10.1186/s12879-023-08028-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study aimed to facilitate the understanding of the transmission route and risk factors that might contribute to the infection of Kaposi's sarcoma associated herpesvirus (KSHV) among men who have sex with men (MSM). METHODS A cross-sectional study of 520 subjects was conducted in Shanghai, China in 2020. Plasma samples were collected and screened for KSHV, HIV, HBV, HCV, and syphilis. Univariate and multivariate logistic regression analyses were conducted to explore potential correlates of KSHV infection. RESULTS The overall seroprevalence of KSHV was 43.8%, with an adjusted value of 29.8% according to the sensitivity and specificity of the KSHV screening assay. Individuals with lower levels of monthly income (Chi-sqauretrend = 4.11, P = 0.043) and more male sex partners (Chi-sqauretrend = 6.06, P = 0.014) were more likely to be infected with KSHV. Also, KSHV seropositivity was positively associated with being a student (aOR = 1.96; 95%CI: 1.09-3.61), being coinfected with HCV (aOR = 2.61; 95%CI: 1.05-7.10), and syphilis (aOR = 2.91; 95%CI: 1.30-6.89). CONCLUSIONS The prevalence of KSHV in MSM remains high. As a risky sexual behavior, having multiple male sex partners is a key contributor to KSHV infection among this population. Efforts designed to control modifiable risk factors in order to reduce the burden of KSHV infection are indispensable. High KSHV seroprevalence among students MSM deserves more attention.
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Liew YCC, Tam YCS, Oh CC. Treatments for AIDS/HIV-related Kaposi sarcoma: A systematic review of the literature. Int J Dermatol 2022; 61:1311-1324. [PMID: 35775738 DOI: 10.1111/ijd.16318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 05/04/2022] [Accepted: 06/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Treatment guidelines are not well established in AIDS-related Kaposi sarcoma (KS). OBJECTIVE We aim to review the evidence on efficacy of treatments for AIDS-related Kaposi sarcoma. METHODS We searched the Cochrane Library, PubMed, and Embase Database from date of database inception till July 2020. Randomized controlled trials reporting intervention consisting of any type of treatment compared to control/placebo to a different treatment modality or different combination of treatment/treatment doses with a diagnosis of AIDS-related KS are selected. MAIN OUTCOMES AND MEASURES Primary outcomes were response rates defined as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Secondary outcomes were cosmesis and adverse outcomes such as pain and erythema. RESULTS Thirteen out of 536 articles met our eligibility criteria. Three studies reported the efficacy of chemotherapy, two studies looked at different doses of radiotherapy regimes, and three studies compared different antiretroviral therapy (ART) and chemotherapy regimens. Other studies reported topical therapies such as alitretinoin gel, IM862, and bHCG injection which showed varied efficacies. LIMITATIONS Lack of standardization classification of disease activity and clinical outcomes and treatment modalities precluded meaningful comparison of studies. CONCLUSION The evidence of efficacy of any particular intervention is overall varied and there was insufficient evidence to recommend any particular intervention. We have provided an overview of treatments for KS but larger studies need to be carried out to verify the efficacy of treatment options reported in the literature.
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Affiliation(s)
| | - Yew Chong Steve Tam
- Department of Education Resource Centre, Medical Board, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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Zhang X, Xu Y, Li Y, Yuan H, Liu Z, Zhang T. Prevalence and correlates of Kaposi's sarcoma-associated herpesvirus and herpes simplex virus type 2 infections among adults: evidence from the NHANES III data. Virol J 2022; 19:5. [PMID: 34991626 PMCID: PMC8740377 DOI: 10.1186/s12985-021-01731-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Kaposi's sarcoma-associated herpes virus (KSHV) prevalence and risk factors exhibit considerable variations across populations in different geographic regions. Determinants and the transmission routes of KSHV infection are uncertain. We seek to identify the possible risk factors and the transmission routes of KSHV infection in non-endemic areas. METHODS We collected annual cases and seroprevalence of KSHV and herpes simplex virus type 2 (HSV-2) from the NHANES III sampled individuals from the US general population (1988-1994). We included 13,179 and 10,720 individuals with available remaining serum samples of KSHV and HSV-2. Logistic regression was employed to explore potential risk factors for the seropositivity. RESULTS The seroprevalence was 2.05% for KSHV infection and 31.03% for HSV2 infection among this population. All risk factors of sexual behaviors included were strongly associated with HSV-2 positive, however, only MSM had an approximately fivefold increased risk of KSHV infection (OR = 4.71; 95%CI 1.61 11.30). Mexican Americans (2.51%) and older (chi-squaretrend = - 6.71, P < 0.001) individuals had a higher risk of KSHV infection. After adjustment, individuals with higher level of education and economic status had lower KSHV infection. CONCLUSIONS In non-endemic areas, KSHV transmission may be related to sexual activity in men, especially in male homosexuals. Higher education level and economic status are protective factors for KSHV infection.
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Affiliation(s)
- Xin Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Yiyun Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Yi Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Huangbo Yuan
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Zhenqiu Liu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200438, China
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China.
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China.
- Yiwu Research Institue, Fudan University, Yiwu, China.
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5
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Consequences of a Delayed Diagnosis of Kaposi's Sarcoma: A Case Report of Disseminated Infection. Infect Dis Rep 2021; 13:161-165. [PMID: 33562058 PMCID: PMC7931081 DOI: 10.3390/idr13010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
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Abstract
Malignancies were one of the earliest recognized manifestations that led to the description of the acquired immune deficiency syndrome (AIDS). The majority of cancers in AIDS patients are associated with coinfection with oncogenic viruses, such as Epstein-Barr virus, human herpesvirus 8, and human papillomavirus, with resulting malignancies occurring secondary to diminished immune surveillance against viruses and virus-infected tumor cells. Over 50% of AIDS lymphomas are associated with Epstein-Barr virus (EBV) and/or HHV8 infection. HHV8-associated diseases include Kaposi sarcoma (KS), primary effusion lymphoma (PEL), and multicentric Castleman disease (MCD). EBV is associated with several malignancies, including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Coinfection with HIV and HPV is associated with an increased risk of various squamous cell carcinomas of epithelial tissues. HAART has significantly impacted the incidence, management, and prognosis of AIDS-related malignancies. In addition to changing the natural history of HIV infection in regard to incidence and survival, HAART has dramatically decreased the incidence of certain virally mediated HIV-associated malignancies such as KS and primary CNS lymphoma. The beneficial effects of HAART on these tumors are attributed to drug-mediated HIV suppression and immune reconstitution. However, HAART has had a less favorable impact on EBV- and HPV-related malignancies. This chapter presents an overview of HIV-associated malignancies mediated by HHV-8, EBV, and HPV, and reviews the effect of HAART on the epidemiology, presentation, treatment, and outcomes of these cancers.
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7
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Semango GP, Charles RM, Swai CI, Mremi A, Amsi P, Sonda T, Shao ER, Mavura DR, Joosten LAB, Sauli E, Nyindo M. Prevalence and associated risk factors for Kaposi's sarcoma among HIV-positive patients in a referral hospital in Northern Tanzania: a retrospective hospital-based study. BMC Cancer 2018; 18:1258. [PMID: 30558571 PMCID: PMC6296123 DOI: 10.1186/s12885-018-5155-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/29/2018] [Indexed: 12/04/2022] Open
Abstract
Background Kaposi’s sarcoma (KS) is a multifocal angioproliferative tumor involving blood and lymphatic vessels, caused by Human Herpes Virus-8 (HHV-8). KS is an important AIDS-defining tumor with high prevalence in Sub-Saharan Africa, including Tanzania which has high HIV and HHV-8 sero-prevalence. It is critically important to monitor the prevalence of AIDS-defining tumors, such as KS, in the age of HIV/AIDS. We studied the prevalence of KS and associated risk factors among HIV-positive patients at Kilimanjaro Christian Medical Centre (KCMC), a referral hospital in northern Tanzania, over the period from January 2012 to December 2015. Methods This was a retrospective hospital-based cross-sectional study to determine the prevalence of KS among HIV/AIDS patients between 2012 and 2015. The study included 1100 HIV patients’ data which were collected at the Infectious Disease Clinic (IDC) from patients’ files. Stata version 13 (StataCorp LP, Texas 77,845 USA) was used for all statistical analyses. The prevalence of KS was calculated across levels of a number of categorical variables. Logistic regression was performed to determine relative risk of KS for all characteristics. We included all variables with p-values ≤10% in the multivariate analysis, including ART use, as this is considered to have an influence on KS. In the multivariate analysis, statistical significance was established based on a two-tailed p-value ≤5%. All patients’ notes were kept confidential as per the Helsinki declaration. Results Our results revealed a 4.6% prevalence of KS at KCMC hospital, between January 2012 and December 2015, 51(4.6%) patients were diagnosed with KS out of 1100 HIV-positive patients. The study further revealed that KS in HIV patients was most associated with low CD4 cell count (less than or equal to 200 cells/μl). Moreover, women were more likely than men to diagnosed with KS, with higher odds significantly associated with KS (OR 0.42, p < 0.009). Increased age, above 35 years, among the HIV seropositive patients was significantly associated with KS (OR 25.67, p < 0.007). HIV patients who were none smokers were more likely to suffer from KS compared to HIV smokers (OR 0.41, p < 0.010). Conclusion KS remains a common malignant vascular tumor commonly associated with HIV/AIDS in Tanzania. Our study highlights the need for continued efforts to combat HIV, as well as associated diseases such as KS. Continued availability of ART (Anti-Retroviral Therapy) to HIV/AIDS patients, and test reagents for CD4 cell count and viral load determination are important measures to alleviate the suffering of these patients. Furthermore, studies to gather more evidence on ART resistance are highly needed to guide treatment choices.
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Affiliation(s)
- George P Semango
- Kilimanjaro Christian Medical University College, P.O Box 2236, Moshi, Tanzania. .,Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, P.O. Box 8332, Moshi, Tanzania. .,School of Life Sciences and Bioengineering, Nelson Mandela-African Institution of Science and Technology, P.O. Box 447, Arusha, Tanzania.
| | - Renard M Charles
- Kilimanjaro Christian Medical University College, P.O Box 2236, Moshi, Tanzania
| | - Consolata I Swai
- Kilimanjaro Christian Medical University College, P.O Box 2236, Moshi, Tanzania.,Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, P.O. Box 8332, Moshi, Tanzania
| | - Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Patrick Amsi
- Department of Pathology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Tolbert Sonda
- Kilimanjaro Christian Medical University College, P.O Box 2236, Moshi, Tanzania
| | - Elichilia R Shao
- Kilimanjaro Christian Medical University College, P.O Box 2236, Moshi, Tanzania.,Department of Medicine, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Daudi R Mavura
- Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre, P.O. Box 8332, Moshi, Tanzania
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud Center for Infectious diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.,Radboud Center for Infectious diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Elingarami Sauli
- School of Life Sciences and Bioengineering, Nelson Mandela-African Institution of Science and Technology, P.O. Box 447, Arusha, Tanzania
| | - Mramba Nyindo
- Kilimanjaro Christian Medical University College, P.O Box 2236, Moshi, Tanzania
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Kaposi Sarcoma and Cutaneous Angiosarcoma: Guidelines for Diagnosis and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Requena C, Alsina M, Morgado-Carrasco D, Cruz J, Sanmartín O, Serra-Guillén C, Llombart B. Kaposi Sarcoma and Cutaneous Angiosarcoma: Guidelines for Diagnosis and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:878-887. [PMID: 30262126 DOI: 10.1016/j.ad.2018.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 06/15/2018] [Accepted: 06/24/2018] [Indexed: 12/20/2022] Open
Abstract
Kaposi sarcoma is a vascular sarcoma with 4 clinical variants: classic Kaposi sarcoma, which mainly affect the extremities of elderly patients and follows a chronic, generally indolent course; African Kaposi sarcoma; immunosuppression-associated Kaposi sarcoma; and AIDS-associated Kaposi sarcoma. Type8 human herpesvirus is the etiologic agent in all 4variants. Cutaneous angiosarcoma is a cutaneous neoplasm with a very poor prognosis. It carries a high probability of local relapse and has a 10% to 15% survival rate at 5years. There are 3 main variants of cutaneous angiosarcoma: idiopathic angiosarcoma of the face and scalp; Stewart-Treves syndrome; and postradiation angiosarcoma. The only potentially curative treatment is surgery with or without radiotherapy. However, its indistinct borders and multicentric nature mean that treatment is often palliative with chemotherapy, radiotherapy, or both.
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Affiliation(s)
- C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - M Alsina
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - J Cruz
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Serra-Guillén
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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10
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Marcoval J, Bonfill-Ortí M, Martínez-Molina L, Valentí-Medina F, Penín RM, Servitje O. Evolution of Kaposi sarcoma in the past 30 years in a tertiary hospital of the European Mediterranean basin. Clin Exp Dermatol 2018; 44:32-39. [PMID: 29934954 DOI: 10.1111/ced.13605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The incidence of Kaposi sarcoma (KS) has reduced as a result of the introduction of antiretroviral therapy. It is currently considered a rare disease in developed countries, and there has been a paucity of clinical papers on the subject in recent years in Europe. AIM To analyse the clinical features and evolution of the different clinical forms of KS in the past 30 years. METHODS Patients with cutaneous lesions of KS diagnosed during the period 1987-2016 at Bellvitge Hospital (an 800-bed university referral centre in Barcelona, Spain) were enrolled. Data recorded included age, sex, ethnicity, involved site, number of lesions, extracutaneous involvement, leg oedema, treatment, blood haemoglobin level, and blood cell (leucocyte, lymphocyte and CD4) counts. RESULTS Cutaneous lesions of KS were diagnosed in 191 patients (167 men, 24 women, mean ± SD age 51.95 ± 20.16 years). Clinical forms identified were classic KS (n = 53), acquired immunodeficiency syndrome (AIDS)-associated KS (n = 118), immunosuppression-associated KS (n = 18), and African endemic KS (n = 2). The number of patients diagnosed annually reached a maximum in the 1990s because of the AIDS epidemic, and has decreased since 2000. However, both classic KS and immunosuppression-associated KS doubled from the first to the second half of the analysed period. Cutaneous lesions involved the legs in 137 cases, and extracutaneous lesions were detected in 32 patients. In 46 of 118 patients with AIDS, the diagnosis of KS was simultaneous to the detection of human immunodeficiency virus infection. CONCLUSION After a decrease in incidence since the middle of the 1990s, AIDS-associated KS continues to occur in Europe, and the number of annual cases of classic KS and immunosuppression-associated KS is increasing.
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Affiliation(s)
- J Marcoval
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - M Bonfill-Ortí
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - L Martínez-Molina
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - F Valentí-Medina
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - R M Penín
- Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - O Servitje
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
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Zhang T, Liu Z, Wang J, Minhas V, Wood C, Clifford GM, He N, Franceschi S. Seroprevalence of antibodies against Kaposi's sarcoma-associated herpesvirus among HIV-negative people in China. Infect Agent Cancer 2017; 12:32. [PMID: 28572838 PMCID: PMC5450136 DOI: 10.1186/s13027-017-0142-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/23/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Little information on the prevalence of Kaposi's sarcoma associated herpesvirus (KSHV) among HIV-negative individuals is available from Asia. METHODS In the present study, we report findings from a new survey of KSHV in 983 HIV-negative male migrants from Shanghai and their combination with previous similar surveys of 600 female migrants, 600 female sex-workers (FSW), 1336 sexually transmitted infection (STI) clinic male patients, 439 intravenous drug-users (IVDU), and 226 men having sex with men (MSM) from China. KSHV-specific antibodies against latent and lytic antigens were assessed using Sf9 and BC3 monoclonal immunofluorescence assay. Age-adjusted prevalence ratios (PR) and 95% confidence interval (95% CI) for KSHV-positivity were estimated using Poisson regression. RESULTS In total, 4184 HIV-negative participants were included. KSHV prevalence ranged from 9.8% (95% CI: 7.9%-11.7%) in male migrants to 32.3% (95% CI: 24.1%-34.1%) in MSM. IVDU show intermediate level (17.5%, 95%CI: 14.1%-21.4%). KSHV was associated with syphilis (PR = 2.03, 95% CI: 1.38-2.98) in MSM but not in other groups. An association with human herpes virus 2 was also found among MSM (PR = 1. 83, 95%: 1.22-2.75) but not in migrant workers or FSW. CONCLUSIONS KSHV prevalence in HIV-negative heterosexuals, FSW, and STI male patients from China is approximately 10%, but 2- and 3-fold higher in IVDU and MSM, respectively. Associations of KSHV with STIs among MSM only suggest that sexual transmission of the virus is important in MSM but not in heterosexuals.
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Affiliation(s)
- Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Zhenqiu Liu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Jun Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Veenu Minhas
- Nebraska Center of Virology and the School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, USA
| | - Charles Wood
- Nebraska Center of Virology and the School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, USA
| | - Gary M. Clifford
- International Agency for Research on Cancer, 69372 Lyon, Cedex 08 France
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, China
| | - Silvia Franceschi
- International Agency for Research on Cancer, 69372 Lyon, Cedex 08 France
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12
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Abstract
Now clear evidences are available to support the hypothesis that inflammation accelerates the conditions including events and molecules that reach to various types of cancers. Inflammation is a normal response to infection containing the innate and adaptive immune systems. However, when allowed to continue, unresolved, perturbation of cellular microenvironment takes place; therefore, it leads to adaptations in genes that are linked to cancer. In addition, a lot of data are accessible confirming the concept that tumour microenvironment is orchestrated by various inflammatory cells and goes to neoplastic process and finally invasion, migration and metastasis. However, infiltrations of leucocytes lead to angiogenesis, propagation and invasion. An inflammatory microenvironment that perhaps fostering impact of angiogenesis include cytokines, chemokines, enzymes and growth factors that play key role for expansion and invasion of cancer cells. This insight highlights the pathogenesis of inflammation-associated cancers and also touches and fosters the role of acetamides for the treatment and chemoprevention of carcinomas that are allied with inflammation.
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Affiliation(s)
- Priyanka Rani
- a Department of Chemistry , School of Sciences, IFTM University Moradabad , Uttar Pradesh , India
| | - Dilipkumar Pal
- b Department of Pharmaceutical Sciences , Guru Ghasidas Vishwavidyalaya (A Central University) , Koni, Bilaspur , CG , India
| | - Rahul Rama Hegde
- c Department of Pharmaceutics , School of Pharmaceutical Sciences, IFTM University Moradabad , Uttar Pradesh , India
| | - Syed Riaz Hashim
- d Department of Chemistry , School of Pharmaceutical Sciences, IFTM University Moradabad , Uttar Pradesh , India
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13
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Morris SR, Zhao M, Smith DM, Vargas MV, Little SJ, Gianella S. Longitudinal Viral Dynamics in Semen During Early HIV Infection. Clin Infect Dis 2017; 64:428-434. [PMID: 28174909 PMCID: PMC5849030 DOI: 10.1093/cid/ciw784] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/18/2016] [Indexed: 12/30/2022] Open
Abstract
Background Multiple viruses coinfect the male genital tract, influencing each other’s replication and perhaps affecting human immunodeficiency virus (HIV) pathogenesis and disease progression. Methods This study included 453 longitudinal seminal samples from 195 HIV-infected men from the San Diego Primary Infection Resource Consortium and 67 seminal samples from HIV-negative healthy controls. Seminal HIV RNA and DNA from 7 human herpesviruses (HHVs) were measured by real-time polymerase chain reaction. Longitudinal shedding rates were determined by Kaplan-Meier survival analysis. Predictors of viral shedding were determined using backwards selection in a multivariable generalized estimating equation model. Results HIV-infected participants presented significantly increased rates of seminal HHV shedding compared with HIV-uninfected controls. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were the most commonly detected HHV in semen of HIV-infected participants. Persistent shedding was more common for CMV and EBV when compared to other HHVs. With exception of HHV-7, HHV shedding was not significantly influenced by HIV RNA levels, CD4+ cell counts, or antiretroviral therapy. Presence of CMV, EBV, and herpes simplex virus (HSV) were independent predictors of genital HIV RNA shedding after adjusting for plasma HIV RNA and longitudinal measurements. Conclusions Seminal replication of multiple HHVs is common in our HIV primary infection cohort. Genital replication of CMV and EBV was the most common and was significantly associated with seminal HIV RNA shedding. Prevalence of HSV shedding was lower and mostly intermittent, but its association with seminal HIV RNA was the strongest. Understanding the complex viral milieu in semen is important for HIV transmission but might also play a role in HIV pathogenesis and disease progression.
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Affiliation(s)
| | | | - Davey M Smith
- University of California, San Diego, La Jolla
- Veterans Affairs San Diego Healthcare System, San Diego, California
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14
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Newton R, Whitby D. Beral et al's 1990 paper on Kaposi's sarcoma among persons with AIDS: demonstrating the power of descriptive epidemiology. Cancer Epidemiol 2016; 44:222-225. [PMID: 27554680 DOI: 10.1016/j.canep.2016.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/18/2016] [Accepted: 07/21/2016] [Indexed: 11/16/2022]
Abstract
Here we discuss the impact of Beral et al's 1990 paper "Kaposi's sarcoma among persons with AIDS: a sexually transmitted infection?" Not only did this paper galvanise research into the underlying infectious cause of Kaposi's sarcoma, it also demonstrated the power of observational epidemiology in pointing the way towards major discoveries.
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Affiliation(s)
- Robert Newton
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda; Department of Health Sciences, University or York, UK.
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
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Hesamizadeh K, Keyvani H, Bokharaei-Salim F, Monavari SH, Esghaei M, Jahanbakhsh Sefidi F. Molecular Epidemiology of Kaposi's Sarcoma-Associated Herpes Virus, and Risk Factors in HIV-infected Patients in Tehran, 2014. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e32603. [PMID: 28191343 PMCID: PMC5292624 DOI: 10.5812/ircmj.32603] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/26/2015] [Accepted: 11/24/2015] [Indexed: 12/15/2022]
Abstract
Background Kaposi’s sarcoma (KS) remains the most common malignancy among HIV-infected patients. Human herpesvirus type-8 (HHV-8) is regarded as the infectious etiological agent of Kaposi’s sarcoma (KSHV). Diagnostic procedures associated with KSHV are not routinely performed in HIV-infected subjects. Objectives The main objective of this study is to obtain information on KSHV epidemiology in Iranian HIV-infected individuals. Patients and Methods In the present cross-sectional study, 109 patients with established HIV infection, who visited a governmental and referral center for HIV screening in Tehran (Tehran west health center (TWHC)) between May 2014 and July 2015 were enrolled according to the convenience sample strategy. After peripheral blood collection, isolation of plasma and peripheral blood mononuclear cell (PBMC) compartments, DNA extraction was performed. KSHV DNA was analyzed by nested polymerase chain reaction (nested PCR) using primers from ORF-26 (virus minor capsid). Results Among all 109 HIV-infected patients, 67 (61.5%) were male, with an age range of 2 - 64 years (mean ± standard deviation 35.8 ± 13.3). KSHV DNA was found in PBMC and plasma samples of six (5.5%) and four (3.6%) patients, respectively. Conclusions This study revealed a considerable prevalence of KSHV DNA, during latent and lytic phases, among HIV-infected patients. Risk factors for KSHV infection acquisition and concurrent. 0+infection with HIV were also evaluated. Diagnosis of KSHV in the group could be helpful for prognosis of Kaposi’s sarcoma and clinical management.
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Affiliation(s)
- Khashayar Hesamizadeh
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
- Middle East Liver Diseases (MELD) Center, Tehran, IR Iran
| | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
| | - Farah Bokharaei-Salim
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
- HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, IR Iran
| | | | - Maryam Esghaei
- Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Maryam Esghaei, Department of Virology, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2186703014, E-mail:
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Yanik EL, Clarke CA, Snyder JJ, Pfeiffer RM, Engels EA. Variation in Cancer Incidence among Patients with ESRD during Kidney Function and Nonfunction Intervals. J Am Soc Nephrol 2016; 27:1495-504. [PMID: 26563384 PMCID: PMC4849829 DOI: 10.1681/asn.2015040373] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 08/05/2015] [Indexed: 01/07/2023] Open
Abstract
Among patients with ESRD, cancer risk is affected by kidney dysfunction and by immunosuppression after transplant. Assessing patterns across periods of dialysis and kidney transplantation may inform cancer etiology. We evaluated 202,195 kidney transplant candidates and recipients from a linkage between the Scientific Registry of Transplant Recipients and cancer registries, and compared incidence in kidney function intervals (time with a transplant) with incidence in nonfunction intervals (waitlist or time after transplant failure), adjusting for demographic factors. Incidence of infection-related and immune-related cancer was higher during kidney function intervals than during nonfunction intervals. Incidence was most elevated for Kaposi sarcoma (hazard ratio [HR], 9.1; 95% confidence interval (95% CI), 4.7 to 18), non-Hodgkin's lymphoma (HR, 3.2; 95% CI, 2.8 to 3.7), Hodgkin's lymphoma (HR, 3.0; 95% CI, 1.7 to 5.3), lip cancer (HR, 3.4; 95% CI, 2.0 to 6.0), and nonepithelial skin cancers (HR, 3.8; 95% CI, 2.5 to 5.8). Conversely, ESRD-related cancer incidence was lower during kidney function intervals (kidney cancer: HR, 0.8; 95% CI, 0.7 to 0.8 and thyroid cancer: HR, 0.7; 95% CI, 0.6 to 0.8). With each successive interval, incidence changed in alternating directions for non-Hodgkin's lymphoma, melanoma, and lung, pancreatic, and nonepithelial skin cancers (higher during function intervals), and kidney and thyroid cancers (higher during nonfunction intervals). For many cancers, incidence remained higher than in the general population across all intervals. These data indicate strong short-term effects of kidney dysfunction and immunosuppression on cancer incidence in patients with ESRD, suggesting a need for persistent cancer screening and prevention.
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Affiliation(s)
- Elizabeth L Yanik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland;
| | - Christina A Clarke
- Cancer Prevention Institute of California, Fremont, California; Department of Health Research and Policy, Stanford University School of Medicine and Stanford Cancer Institute, Palo Alto, California
| | - Jon J Snyder
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota; and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Eric A Engels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Pinzone MR, Berretta M, Cacopardo B, Nunnari G. Epstein-Barr Virus– and Kaposi Sarcoma-Associated Herpesvirus–Related Malignancies in the Setting of Human Immunodeficiency Virus Infection. Semin Oncol 2015; 42:258-71. [DOI: 10.1053/j.seminoncol.2014.12.026] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Abstract
The known human tumor viruses include the DNA viruses Epstein-Barr virus (EBV), Kaposi sarcoma herpesvirus (KSHV), Merkel cell polyomavirus (MCPyV), human papillomavirus (HPV), and hepatitis B virus (BV). RNA tumor viruses include human T-cell lymphotrophic virus type 1 (HTLV-1) and hepatitis C virus (HCV). The serological identification of antigens/antibodies in serum is a rapidly progressing field with utility for both scientists and clinicians. Serology is useful for conducting seroepidemiology studies and to inform on the pathogenesis and host immune response to a particular viral agent. Clinically, serology is useful for diagnosing current or past infection and for aiding in clinical management decisions. Serology is useful for screening blood donations for infectious agents and for monitoring the outcome of vaccination against these viruses. Serodiagnosis of human tumor viruses has improved in recent years with increased specificity and sensitivity of the assays, as well as reductions in cost and the ability to assess multiple antibody/antigens in single assays. Serodiagnosis of tumor viruses plays an important role in our understanding of the prevalence and transmission of these viruses and ultimately in the ability to develop treatments/preventions for these globally important diseases.
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Affiliation(s)
- Brian J Morrison
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Wendell J Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD.
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Zhang T, Liu Y, Zhang Y, Wang J, Minhas V, Wood C, He N. Seroprevalence of human herpesvirus 8 and hepatitis C virus among drug users in Shanghai, China. Viruses 2014; 6:2519-30. [PMID: 24960274 PMCID: PMC4074941 DOI: 10.3390/v6062519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/02/2014] [Accepted: 06/06/2014] [Indexed: 12/24/2022] Open
Abstract
To elucidate and compare the seroprevalence of human herpesvirus 8 (HHV8) and hepatitis C virus (HCV) among Chinese drug users, a cross-sectional study of 441 participants, was conducted in Shanghai, China, from 2012 through 2013. Seventy-seven (17.5%) participants were found to be positive for HHV8 antibodies, while 271 (61.5%) participants were positive for HCV. No significant association between HHV8 seropositivity and drug use characteristics, sexual behaviors, HCV, or syphilis was observed. In contrast, a statistically significant association between HCV seropositivity and injected drug history (OR, 2.18, 95% CI 1.41–3.37) was detected, whereas no statistically significant association between HCV seropositivity and syphilis infection (OR, 7.56, 95% CI 0.94–60.57) were observed. Pairwise comparisons showed no significant differences between latent and lytic antibodies regarding HCV and HHV8 serostatus. The study demonstrated a moderate but elevated prevalence of HHV8 infection among drug users. The discordance between HHV8 and HCV infections suggests that blood borne transmission of HHV8 might not be the predominant mode of transmission in this population, which is in contrast to HCV.
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Affiliation(s)
- Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China.
| | - Ying Liu
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China.
| | - Yuyan Zhang
- Putuo District Center for Disease Control and Prevention, Shanghai 200032, China.
| | - Jun Wang
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China.
| | - Veenu Minhas
- Nebraska Center for Virology, School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA.
| | - Charles Wood
- Nebraska Center for Virology, School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA.
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China.
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Lee YM, Chuang SY, Wang SF, Lin YT, Chen YMA. Epidemiology of human herpesvirus type 8 and parvovirus B19 infections and their association with HIV-1 among men who have sex with men and injection drug users in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 47:233-8. [DOI: 10.1016/j.jmii.2013.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 12/10/2012] [Accepted: 01/22/2013] [Indexed: 10/27/2022]
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Labo N, Miley W, Marshall V, Gillette W, Esposito D, Bess M, Turano A, Uldrick T, Polizzotto MN, Wyvill KM, Bagni R, Yarchoan R, Whitby D. Heterogeneity and breadth of host antibody response to KSHV infection demonstrated by systematic analysis of the KSHV proteome. PLoS Pathog 2014; 10:e1004046. [PMID: 24675986 PMCID: PMC3968157 DOI: 10.1371/journal.ppat.1004046] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 02/17/2014] [Indexed: 01/15/2023] Open
Abstract
The Kaposi sarcoma associated herpesvirus (KSHV) genome encodes more than 85 open reading frames (ORFs). Serological evaluation of KSHV infection now generally relies on reactivity to just one latent and/or one lytic protein (commonly ORF73 and K8.1). Most of the other polypeptides encoded by the virus have unknown antigenic profiles. We have systematically expressed and purified products from 72 KSHV ORFs in recombinant systems and analyzed seroreactivity in US patients with KSHV-associated malignancies, and US blood donors (low KSHV seroprevalence population). We identified several KSHV proteins (ORF38, ORF61, ORF59 and K5) that elicited significant responses in individuals with KSHV-associated diseases. In these patients, patterns of reactivity were heterogeneous; however, HIV infection appeared to be associated with breadth and intensity of serological responses. Improved antigenic characterization of additional ORFs may increase the sensitivity of serologic assays, lead to more rapid progresses in understanding immune responses to KSHV, and allow for better comprehension of the natural history of KSHV infection. To this end, we have developed a bead-based multiplex assay detecting antibodies to six KSHV antigens.
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Affiliation(s)
- Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - William Gillette
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Dominic Esposito
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Matthew Bess
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Alexandra Turano
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Thomas Uldrick
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Mark N. Polizzotto
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Kathleen M. Wyvill
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Rachel Bagni
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Robert Yarchoan
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
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Zhang T, Yang Y, Yu F, Zhao Y, Lin F, Minhas V, Wood C, He N. Kaposi`s sarcoma associated herpesvirus infection among female sex workers and general population women in Shanghai, China: a cross-sectional study. BMC Infect Dis 2014; 14:58. [PMID: 24498947 PMCID: PMC3927852 DOI: 10.1186/1471-2334-14-58] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 02/04/2014] [Indexed: 12/21/2022] Open
Abstract
Background Limited information on epidemiologic patterns of KSHV, with none focusing on heterosexual transmission, is available in mainland China. To clarify this, a cross-sectional study was conducted among a group of female sex workers (FSW) and general population women (GW) in Shanghai, China. Methods An anonymous questionnaire interview was administrated among 600 FSW and 600 GW. Blood samples were collected and tested for antibodies to KSHV, HSV-2, HIV, syphilis and HBsAg. Correlates of KSHV and HSV-2 were examined using multiple logistic regression analysis. Results None of the study participants were tested positive for HIV. The seroprevalence of KSHV, HSV-2 , HBV and syphilis was 10.0%, 52.2%, 12.3% and 10.5%, respectively for FSW, and was 11.0%, 15.3%, 9.8% and 2.8%, respectively for GW. KSHV seropositivity was not associated with syphilis and HSV-2 infection as well as sexual practices among either FSW or GW. Nevertheless, HSV-2 infection among FSW was independently associated with being ever married (OR = 1.59; 95%CI: 1.04-2.45), >5 years of prostitution (OR = 2.06; 95%CI: 1.16-3.68) and being syphilis positive (OR = 2.65; 95%CI: 1.43-4.93). HSV-2 infection among GW was independently associated with an age of >35 years (OR = 2.29; 95%CI: 1.07-4.93), having had more than 2 sex partners in the prior 12 months (OR = 6.44; 95%CI: 1.67-24.93) and being syphilis positive (OR = 3.94; 95%CI: 1.38-11.23). A gradual increase of prevalence with the prostitution time group was also detected for HSV-2 and syphilis, but not for KSHV. Conclusions KSHV is moderately and equivalently prevalent among FSW and GW. Heterosexual contact is not a predominant route for KSHV transmission among Chinese women.
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Affiliation(s)
| | | | | | | | | | | | | | - Na He
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
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Wu XJ, Pu XM, Kang XJ, Halifu Y, An CX, Zhang DZ, Yakeya B, Mijit J. One hundred and five Kaposi sarcoma patients: a clinical study in Xinjiang, Northwest of China. J Eur Acad Dermatol Venereol 2013; 28:1545-52. [PMID: 25350316 DOI: 10.1111/jdv.12349] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 11/18/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Kaposi's sarcoma (KS) is an unusual illness that may be associated with human herpes virus 8 (HHV-8) infections, and appears mainly in Jews, Italians and Greeks. There is a lack of patient data in Xinjiang regarding the clinical characteristics of KS. OBJECTIVES To review the clinical characteristics of a series of patients with KS in Xinjiang, Northwest China, over 16-year period. METHODS A retrospective analysis of patients referred to a Xinjiang hospital in Northwest China with classic KS (CKS) and AIDS-associated KS (AIDS-KS) between January 1997 and April 2013 was performed. Reviewed information included demographics, clinical features, histopathological traits, treatment and presence of HHV-8 infection. RESULTS During the study period, 105 patients with a diagnosis of KS, including 77 CKS and 28 AIDS-KS, were referred to our hospital. Mean age at diagnosis was 55.8 ± 16.8 years (range: 25-85 years). There were 70 (90.9%) males and 7 (9.1%) females (male-to-female ratio: 10 : 1) having CKS and 21 (75.0%) males and 7 (25.0%) females (male-to-female ratio: 3 : 1) with AIDS-KS. Most of the patients were Uyghur, including 67 CKS and 24 AIDS-KS. The rate of multifocal lesions at diagnosis was 98.1% (103/105). The most common area of lesions was between 1% and 5% of CKS and AIDS-KS. The main types of lesions were nodules, patches and plaques. The lower extremity and foot were the most common locations for CKS and AIDS-KS. In addition to skin damage, the penis, mouth, lymph nodes and interstitial lung tissues were involved in some cases. No second primary malignancy was diagnosed. Systemic chemotherapy and radiotherapy were effective treatments for CKS. The HHV-8 positivity rate was 98.98% in 98 KS cases. CONCLUSIONS In Xinjiang, most CKS and AIDS-KS patients were older Uyghur men. AIDS-KS was found predominantly among 30-year-old Uyghur patients, compared with 60 years for those having CKS. The latter exhibited certain characteristics such as disseminated skin disease; in some patients, the condition was accompanied by lymphedema, visceral or lymph node involvement, but no secondary malignancies. In addition, the HHV-8 positivity rate associated with KS was very high.
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Affiliation(s)
- X-J Wu
- Department of Dermatology, People's Hospital of Xinjiang, Uygur Autonomous Region, Urumqi, China
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Daly ML, Fogo A, McDonald C, Morris-Jones R. Kaposi sarcoma: no longer an AIDS-defining illness? A retrospective study of Kaposi sarcoma cases with CD4 counts above 300/mm3at presentation. Clin Exp Dermatol 2013; 39:7-12. [DOI: 10.1111/ced.12163] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 11/27/2022]
Affiliation(s)
- M.-L. Daly
- Department of Dermatology; King's College Hospital NHS Foundation Trust; London U.K
| | - A. Fogo
- Department of Dermatology; King's College Hospital NHS Foundation Trust; London U.K
| | - C. McDonald
- Department of Genito-Urinary Medicine; King's College Hospital NHS Foundation Trust; London UK
| | - R. Morris-Jones
- Department of Dermatology; King's College Hospital NHS Foundation Trust; London U.K
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Sachithanandham J, Kannangai R, Abraham A, Fletcher G, Abraham O, Daniel D, Pulimood S. Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India. Intervirology 2013; 56:253-7. [DOI: 10.1159/000349890] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 02/12/2013] [Indexed: 11/19/2022] Open
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Prevalence and correlates of Kaposi's sarcoma-associated herpesvirus infection in a sample of men who have sex with men in eastern China. Epidemiol Infect 2012; 141:1823-30. [DOI: 10.1017/s0950268812002361] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYThis study aimed to determine the seroprevalence of Kaposi's sarcoma-associated herpesvirus (KSHV) and related factors in men who have sex with men (MSM) in China. A total of 208 subjects were recruited from eastern China from 2008 to 2009. Plasma samples were collected and screened for KSHV, HIV and syphilis. Overall, KSHV seroprevalence was 32·7% in the subjects. About 92·7% of subjects reported having ever had anal sex with a man, of whom 67·8% had receptive anal sex and 77·9% had insertive anal sex. About 93·1% of the study participants reported having had oral sex with a man, of whom 76·0% had receptive oral sex and 56·7% had insertive oral sex. KSHV seropositivity was independently associated with receptive anal sex [odds ratio (OR) 2·68, 95% confidence interval (CI) 1·15–6·23], syphilis (OR 3·25, 95% CI 1·56–6·76) and HSV-2 infection (OR 2·40, 95% CI 1·09–5·26). KSHV infection is highly prevalent and is probably sexually transmitted among MSM in eastern China.
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Zheng D, Wan J, Cho YG, Wang L, Chiou CJ, Pai S, Woodard C, Zhu J, Liao G, Martinez-Maza O, Qian J, Zhu H, Hayward GS, Ambinder RF, Hayward SD. Comparison of humoral immune responses to Epstein-Barr virus and Kaposi's sarcoma-associated herpesvirus using a viral proteome microarray. J Infect Dis 2011; 204:1683-91. [PMID: 21990424 PMCID: PMC3203236 DOI: 10.1093/infdis/jir645] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background. Epstein-Barr virus (EBV) is a ubiquitous herpesvirus, and Kaposi’s sarcoma–associated herpesvirus (KSHV) has a restricted seroprevalence. Both viruses are associated with malignancies that have an increased frequency in individuals who are coinfected with human immunodeficiency virus type 1 (HIV-1). Methods. To obtain an overview of humoral immune responses to these viruses, we generated a protein array that displayed 174 EBV and KSHV polypeptides purified from yeast. Antibody responses to EBV and KSHV were examined in plasma from healthy volunteers and patients with B cell lymphoma or with AIDS-related Kaposi’s sarcoma or lymphoma. Results. In addition to the commonly studied antigens, IgG responses were frequently detected to the tegument proteins KSHV ORF38 and EBV BBRF and BGLF2 and BNRF1 and to the EBV early lytic proteins BRRF1 and BORF2. The EBV vIL-10 protein was particularly well recognized by plasma IgA. The most intense IgG responses to EBV antigens occurred in HIV-1–positive patients. No clear correlation was observed between viral DNA load in plasma and antibody profile. Conclusions. The protein array provided a sensitive platform for global screening; identified new, frequently recognized viral antigens; and revealed a broader humoral response to EBV compared with KSHV in the same patients.
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Affiliation(s)
- Dasheng Zheng
- Viral Oncology Program, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
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Boehmer U, Miao X, Ozonoff A. Cancer survivorship and sexual orientation. Cancer 2011; 117:3796-804. [PMID: 21557209 DOI: 10.1002/cncr.25950] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/22/2010] [Accepted: 01/03/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND Lesbian, gay, and bisexual populations are not part of cancer surveillance, resulting in scarce information about the cancer survivorship of these populations. To address this information gap, the authors examined the prevalence of cancer survivorship by sexual orientation and cancer survivors' self-reported health by sexual orientation. METHODS The authors explored these issues by analyzing pooled data from the California Health Interview survey from 2001, 2003, and 2005. By using descriptive statistics and logistic regressions, they examined the cancer prevalence in men and women by sexual orientation and subsequently compared the self-reported health of male and female cancer survivors by sexual orientation. RESULTS Among women, the authors found no significant differences in cancer prevalence by sexual orientation, but lesbian and bisexual female cancer survivors had 2.0 and 2.3× the odds of reporting fair or poor health compared with heterosexual female cancer survivors. Among men, we found significant differences in cancer prevalence, with gay men having 1.9× the odds of reporting a cancer diagnosis compared with heterosexual men. There were no differences by sexual orientation in male cancer survivors' self-reported health. CONCLUSIONS Our novel findings suggest sex differences in the impact of cancer on lesbian, gay, and bisexual cancer survivors. Lesbian and bisexual cancer survivors need to be targeted by programs and services to assist these cancer survivors in improving their health perceptions, whereas healthcare providers and public health agencies need to be made aware of the higher prevalence of cancer in gay men to prevent future cancers through increased screening and primary prevention.
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Affiliation(s)
- Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts 02118, USA.
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Uldrick TS, Whitby D. Update on KSHV epidemiology, Kaposi Sarcoma pathogenesis, and treatment of Kaposi Sarcoma. Cancer Lett 2011; 305:150-62. [PMID: 21377267 DOI: 10.1016/j.canlet.2011.02.006] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 02/03/2011] [Accepted: 02/04/2011] [Indexed: 12/29/2022]
Abstract
Much has been learned since the discovery of KSHV in 1994 about its epidemiology and pathology but much of what has been learned has yet to be translated into clinical practice. In this review, we survey the current state of knowledge on KSHV epidemiology and KS pathogenesis and highlight therapeutic opportunities in both the developed and developing world.
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Affiliation(s)
- Thomas S Uldrick
- HIV and AIDS Malignancy Branch, National Cancer Institute/NIH, Bethesda, MD 20892, USA.
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Xie Y, Ruan B, Chen Y, Wu N, Hu M, Zhu B. Kaposi's sarcoma-associated herpesvirus infection in Chinese patients with chronic hepatitis B. J Med Virol 2011; 83:879-83. [DOI: 10.1002/jmv.22001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2010] [Indexed: 11/11/2022]
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Marshall V, Martró E, Labo N, Ray A, Wang D, Mbisa G, Bagni RK, Volfovsky N, Casabona J, Whitby D. Kaposi sarcoma (KS)-associated herpesvirus microRNA sequence analysis and KS risk in a European AIDS-KS case control study. J Infect Dis 2010; 202:1126-35. [PMID: 20715927 PMCID: PMC2932837 DOI: 10.1086/656045] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We recently identified polymorphisms in Kaposi sarcoma-associated herpesvirus (KSHV)-encoded microRNA (miRNA) sequences from clinical subjects. Here, we examine whether any of these may contribute to KS risk in a European AIDS-KS case-control study. METHODS KSHV load in peripheral blood was determined by real-time quantitative polymerase chain reaction. Samples that had detectable viral loads were used to amplify the 2.8-kb miRNA encoding region plus a 646-bp fragment of the K12/T0.7 gene. Additionally, we characterized an 840-bp fragment of the K1 gene to determine KSHV subtypes. RESULTS KSHV DNA was detected in peripheral blood mononuclear cells of 49.6% of case patients and 6.8% of controls, and viral loads tended to be higher in case patients. Sequences from the miRNA-encoding regions were conserved overall, but distinct polymorphisms were detected, some of which occurred in primary miRNAs, pre-miRNAs, or mature miRNAs. CONCLUSIONS Patients with KS were more likely to have detectable viral loads than were controls without disease. Despite high conservation in KSHV miRNA-encoded sequences, polymorphisms were observed, including some that have been reported elsewhere. Some polymorphisms could affect mature miRNA processing and appear to be associated with KS risk.
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Affiliation(s)
- Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Elisa Martró
- Microbiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- CIBER de Epidemiologia y Salud Publica (CIBERESP), Spain
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Alex Ray
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Dian Wang
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Georginia Mbisa
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Rachel K. Bagni
- Molecular Detection Group, Protein Expression Laboratory, Advanced Technology Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Natalia Volfovsky
- Advanced Biomedical Computing Center, Information Systems Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
| | - Jordi Casabona
- Centre dEstudis Epidemiologics sobre l’ HIV/SIDS de Catalunya, Department de Salut, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, NCI-Frederick, Frederick, MD
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Abstract
Kaposi's sarcoma (KS) is the most common cancer in HIV-infected untreated individuals. Kaposi's sarcoma-associated herpesvirus (KSHV; also known as human herpesvirus 8 (HHV8)) is the infectious cause of this neoplasm. In this Review we describe the epidemiology of KS and KSHV, and the insights into the remarkable mechanisms through which KSHV can induce KS that have been gained in the past 16 years. KSHV latent transcripts, such as latency-associated nuclear antigen (LANA), viral cyclin, viral FLIP and viral-encoded microRNAs, drive cell proliferation and prevent apoptosis, whereas KSHV lytic proteins, such as viral G protein-coupled receptor, K1 and virally encoded cytokines (viral interleukin-6 and viral chemokines) further contribute to the unique angioproliferative and inflammatory KS lesions through a mechanism called paracrine neoplasia.
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Affiliation(s)
- Enrique A Mesri
- Viral Oncology Program, Developmental Center for AIDS Research, and Department of Microbiology & Immunology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1,550 NW 10th Avenue, 109 Papanicolau Building, Miami, Florida 33136, USA.
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Kaposi sarcoma herpes virus antibody response and viremia following highly active antiretroviral therapy in the Swiss HIV Cohort study. AIDS 2010; 24:2245-52. [PMID: 20543658 DOI: 10.1097/qad.0b013e32833b7830] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To describe the effect of HAART on Kaposi sarcoma herpes virus (KSHV) antibody response and viremia among HIV-positive MSM. DESIGN A follow-up study of 272 HIV-positive MSM (including 22 with Kaposi sarcoma) who first initiated HAART between January 1996 and July 2004 in the Swiss HIV Cohort Study. METHODS For each individual, two serum samples, one at HAART initiation and another 24 months later, were tested for latent and lytic KSHV antibodies using immunofluorescence assays, and for KSHV viremia using PCR. Factors associated with changes in KSHV antibody titers and viremia were evaluated. RESULTS At HAART initiation, 69.1 and 75.0% of patients were seropositive to latent and lytic KSHV antibodies, respectively. Seropositivity was associated with the presence of Kaposi sarcoma, older age, lower CD8 cell count and higher CD4/CD8 ratio. Prevalence of KSHV viremia at HAART initiation was 6.4%, being significantly higher among patients with Kaposi sarcoma (35.0%), and those with HIV viral loads 100 000 copies/ml (11.7%) or higher. At 24-month follow-up, geometric mean titers (GMTs) among KSHV seropositive patients increased and antibody seroprevalence was higher. Having Kaposi sarcoma and/or CD4 cell counts less than 50 cells/microl at HAART initiation was associated both with higher probability for antibody titers to increase (including seroconversion) and larger increases in GMTs. Only one of 17 viremic patients at HAART initiation had viremia at 24-month follow-up. CONCLUSION HAART increases KSHV-specific humoral immune response and clearance of viremia among HIV-infected MSM, consistent with the dramatic protection offered by HAART against Kaposi sarcoma.
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Kaposi’s sarcoma of the head and neck: A review. Oral Oncol 2010; 46:135-45. [DOI: 10.1016/j.oraloncology.2009.12.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/17/2009] [Accepted: 12/18/2009] [Indexed: 12/15/2022]
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Abstract
The human herpesvirus 8 (HHV-8) is the oncogenic virus associated with Kaposi's sarcoma (KS) and lymphoproliferative disorders, namely, primary effusion lymphoma and multicentric Castleman's disease. KS is among the most common malignancies seen in HIV-infected patients despite the decreased incidence of KS in the era of highly active antiretroviral therapy. Advances in molecular pathology reveal HHV-8 tumorigenesis is mediated through molecular mimicry wherein viral-encoded proteins can activate several cellular signaling cascades while evading immune surveillance. This knowledge has led to the evolution of multiple therapeutic strategies against specific molecular targets. Many such therapeutic modalities have shown activity, but none have proven to be curative. Identifying possible prognostic factors is another active area of research. This review summarizes the recent developments in the fields of virus transmission, molecular biology, and treatment of HHV-8-related neoplasms.
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Affiliation(s)
- Meena Sunil
- Department of Hematology/Medical Oncology, Winship Cancer Institute, Emory University, Room 2054, 1365C Clifton Road, Atlanta, GA 30322 USA
| | - Erin Reid
- Hematology/Oncology, Moores Cancer Center, University of California, San Diego, 3855 Health Sciences, MC #0987 La Jolla, CA USA
| | - Mary Jo Lechowicz
- Department of Hematology/Medical Oncology, Winship Cancer Institute, Emory University, Room 2054, 1365C Clifton Road, Atlanta, GA 30322 USA
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Clifford GM, Franceschi S. Cancer risk in HIV-infected persons: influence of CD4(+) count. Future Oncol 2009; 5:669-78. [PMID: 19519206 DOI: 10.2217/fon.09.28] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Persons infected with HIV are at increased risk for all cancers known or suspected to have an infectious cause, an effect believed to be primarily mediated by lowered host immunity via the depletion of CD4(+) cells. Whereas Kaposi sarcoma and non-Hodgkin lymphoma were recognised as AIDS-defining illnesses early in the HIV epidemic, the influence of declining CD4(+) count on other infection-related cancers has taken longer to establish, undoubtedly because the association is weaker and the dose-response relationship is less steep. However, following improved survival made possible by combined antiretroviral therapy, declining CD4(+) count starts showing an impact on the natural history of various carcinogenic infections and on the risk for an increasingly wide range of cancers, including Hodgkin lymphoma, cervical, anal and liver cancers.
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Affiliation(s)
- Gary M Clifford
- International Agency for Research on Cancer, Lyon Cedex 08, France.
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Leao JC, Ribeiro CMB, Carvalho AAT, Frezzini C, Porter S. Oral complications of HIV disease. Clinics (Sao Paulo) 2009; 64:459-70. [PMID: 19488613 PMCID: PMC2694251 DOI: 10.1590/s1807-59322009000500014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/18/2009] [Indexed: 12/13/2022] Open
Abstract
Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS.
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Affiliation(s)
- Jair C Leao
- Departamento de Clinica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, PE, Brazil.
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Guanira JV, Casper C, Lama JR, Morrow R, Montano SM, Caballero P, Suárez L, Whittington WLH, Wald A, Sanchez J, Celum C. Prevalence and correlates of human herpesvirus 8 infection among Peruvian men who have sex with men. J Acquir Immune Defic Syndr 2009; 49:557-62. [PMID: 18989224 DOI: 10.1097/qai.0b013e31818d5bf8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infection with human herpesvirus 8 (HHV-8) is common among men who have sex with men (MSM) in North America and Europe and is also found to be endemic in some regions of South America. Little is known about HHV-8 prevalence and its correlates among MSM in the Andean region. METHODS We assessed HHV-8 seroprevalence among 497 MSM recruited for the 2002 Peruvian HIV sentinel surveillance program using a combined HHV-8 enzyme immunoassay and immunofluorescence assay algorithm. Logistic regression analysis was used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) to determine the association between selected covariates and HHV-8 seropositivity. RESULTS One hundred thirty-one (66.5%, 95% CI 63.1% to 69.9%) of 197 HIV-infected and 80 (26.7%, 95% CI 24.4% to 29.0%) of 300 HIV-uninfected MSM had serologic evidence of HHV-8 infection. Factors independently associated with HHV-8 infection were education<12 years (OR 1.7, 95% CI 1.1 to 2.7), anal receptive sex with the last partner (OR 2.0, 95% CI 1.2 to 3.3), self-reported sexually transmitted infection symptoms during the last year (OR 1.9, 95% CI 1.2 to 3.0), coinfection with HIV (OR 4.2, 95% CI 2.8 to 6.4) and chronic hepatitis B (OR 4.9, 95% CI 1.5 to 15.8). MSM with long-standing HIV infection were more likely to have serologic evidence of HHV-8 infection when compared with men with recently acquired HIV (OR 3.8, 95% CI 1.7 to 9.1). CONCLUSIONS HHV-8 infection is common among both HIV-infected and HIV-negative MSM in Lima, Peru. HHV-8 seropositivity is correlated with anal receptive sex, self-reported sexually transmitted infection symptoms, and HIV infection among these MSM and thus seems to be sexually transmitted. HHV-8 infection seems to be acquired after HIV infection, suggesting that future studies should evaluate the mode of HHV-8 transmission and prevention strategies among HIV-uninfected MSM.
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McDonald AC, Ragin CC, Jenkins FJ, Weissfeld J, Wilson J, Wheeler VW, Wilson JB, Bunker CH, Taioli E. Human herpesvirus 8 seroprevalence among Tobago women and the role of sexual lifestyle behavior. J Med Virol 2009; 81:264-70. [PMID: 19107975 DOI: 10.1002/jmv.21346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Human herpesvirus 8 (HHV-8) infection is present in 22.9% of Tobago men. However, seroprevalence and modes of transmission of HHV-8 among Tobago women are not known. HHV-8 seropositivity rates in Tobago women were examined and compared rates to Tobago men of similar ages. To assess possible modes of transmission, sexual behavior among Tobago women was examined to determine its association with HHV-8 seropositivity. A cross-sectional study was conducted in 213 Tobago women, ages 18-65 years, who participated in the Tobago Cervical and Oral Cancer Screening Study. HHV-8 seropositivity was determined by a monoclonal immunofluorescence assay. Age-specific rates were compared to those previously observed in men. Logistic regression analyses were performed to determine the association between HHV-8 seropositivity and sexual behavior among the women. HHV-8 seroprevalence among Tobago women was 14.1% (95% CI, 10-19%), with no significant difference with men of similar age (P-value = 0.741). Age <or=17 years at first sexual intercourse was found to have a minimal significant association with HHV-8 seropositivity (OR = 2.51, 95% CI = 1.09-5.78) in women. HHV-8 age-specific rates were similar between genders. Sexual activity may not be a major contributor to HHV-8 infection among Tobago women.
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Affiliation(s)
- Alicia C McDonald
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Powles T, Stebbing J, Bazeos A, Hatzimichael E, Mandalia S, Nelson M, Gazzard B, Bower M. The role of immune suppression and HHV-8 in the increasing incidence of HIV-associated multicentric Castleman's disease. Ann Oncol 2009; 20:775-9. [PMID: 19179554 DOI: 10.1093/annonc/mdn697] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In HIV cohorts with access to highly active antiretroviral therapy (HAART), the incidence of Kaposi's sarcoma (KS) is falling; however, the incidence of multicentric Castleman's disease (MCD) in HIV has not previously been described. METHODS The incidence of HIV-associated MCD was calculated from a prospective HIV database with 56 202 patient-years of follow-up and compared with KS. Univariate and multivariate analyses were carried out to identify factors associated with MCD. Plasma human herpesvirus (HHV)-8 DNA levels were measured in HIV-seropositive individuals with newly diagnosed MCD (n = 24), KS (n = 72), HIV-associated lymphoma (n = 74) and HIV-positive controls (n = 53). RESULTS From 24 cases of HIV-associated MCD, the incidence measured 4.3/10,000 patient-years [95% confidence interval (CI) 2.7-6.4]. The incidence in the pre-HAART (1983-1996), early-HAART (1997-2001) and later HAART (2002-2007) eras were 2.3 (95% CI 0.02-4.2), 2.8 (95% CI 0.9-6.5) and 8.3 (95% CI 4.6-12.6), respectively, representing a statistically significant increase over time (P < 0.05). In contrast, from 1180 cases of KS, the incidence in this cohort decreased with time. Multivariate analysis demonstrated that a nadir CD4 count >200/mm(3), increased age, no previous HAART exposure and non-Caucasian ethnicity were all associated with an increased risk of MCD. Plasma HHV-8 DNA levels were higher in patients with newly diagnosed MCD than with KS, lymphomas or HIV-positive controls (Mann-Whitney U-test, P < 0.0001). CONCLUSIONS The incidence of HIV-associated MCD is increasing. It appears to occur more frequently in older HIV-positive individuals with well-preserved immune function.
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Affiliation(s)
- T Powles
- Department of Medical Oncology, Barts and the London Medical School, London, UK
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Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: a continuing conundrum. J Am Acad Dermatol 2008; 59:179-206; quiz 207-8. [PMID: 18638627 DOI: 10.1016/j.jaad.2008.05.001] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 04/20/2008] [Accepted: 05/05/2008] [Indexed: 12/11/2022]
Abstract
UNLABELLED Kaposi sarcoma (KS) remains a challenge. Its classic or Mediterranean form tends to be benign. In transplant recipients it may be less so. As part of the AIDS pandemic, of which it was an original defining component, it may be life-threatening. It is due to human herpesvirus-8, which is necessary but not sufficient to produce the disease. KS has a low prevalence in the general population of the United States and United Kingdom, with an intermediate rate in Italy and Greece, and a high one in parts of Africa. In Italy, hot spots include its southern regions, the Po River Valley, and Sardinia, possibly related to a high density of blood-sucking insects. An important challenge is to treat KS patients without immunocompromising them. The potential of effective anti-herpes virus therapy and the use of sirolimus in transplantation recipients have added new opportunities for KS prevention. LEARNING OBJECTIVES At the conclusion of this learning activity, participants should be able to provide the most recent information about Kaposi sarcoma in the context in which it occurs. Its classic or Mediterranean form, its pattern in transplant recipients and others iatrogenically immunosuppressed, and its occurrence as a potentially life-threatening part of the AIDS pandemic will be stressed. Its etiology and transmission will be discussed in detail to facilitate understanding of Kaposi sarcoma and of human herpesvirus-8 infection in the general population of the United States and United Kingdom, in Italy and Greece, and in certain parts of Africa. Its therapy, including the concept of doing it without immunocompromising the patient, will be stressed. New opportunities for Kaposi sarcoma prevention will also be discussed.
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Affiliation(s)
- Robert A Schwartz
- Department of Dermatology, New Jersey Medical School, Newark, New Jersey 07103-2714, USA.
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Abstract
BACKGROUND Four epidemiologic forms of Kaposi's sarcoma have been described, all of which are associated with the human herpesvirus-8. In western countries, human herpesvirus-8 is more prevalent in homosexual men than in the general population, and anecdotal cases of Kaposi's sarcoma in HIV-negative homosexual men have been reported. PATIENTS AND METHODS We included HIV-negative homosexual and bisexual male patients with histologically proven Kaposi's sarcoma in a retrospective study. Clinical data were collected using a standardized form. Risk factors for human herpesvirus-8 infection and for the development of Kaposi's sarcoma were systematically recorded. RESULTS Between 1995 and 2007, 28 men met the defined inclusion criteria. Mean age at first symptoms of Kaposi's sarcoma was 53 years. Clinical presentation resembled classical Kaposi's sarcoma, with limited disease in most patients. No cellular or humoral immunodeficiency was observed. Serologic tests for human herpesvirus-8 (latent immunofluorescence assay) were positive in 88% of patients, and only two patients displayed human herpesvirus-8 viremia at the time of Kaposi's sarcoma diagnosis. Three patients developed lymphoproliferative disorders (Castleman disease, follicular lymphoma and Burkitt lymphoma). In this population, alpha-interferon was well tolerated and gave a complete response, but most patients require only local treatment, if any. CONCLUSION Kaposi's sarcoma may develop in homosexual or bisexual men without HIV infection. This type of Kaposi's sarcoma has clinical features in common with classical Kaposi's sarcoma but occurs in younger patients. Its prognosis is good, as Kaposi's sarcoma is generally limited, but clinicians should be aware of the association with lymphoproliferative diseases, which may affect prognosis.
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No evidence of sexual transmission of Kaposi's sarcoma herpes virus in a heterosexual South African population. AIDS 2008; 22:519-26. [PMID: 18301065 DOI: 10.1097/qad.0b013e3282f46582] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The transmission of Kaposi's sarcoma herpes virus (KSHV) in men who have sex with men is clearly associated with sexual risk factors, but evidence of heterosexual transmission of KSHV is conflicting. METHODS Sera were obtained from 2103 South African individuals (862 miners, 95 sex workers, 731 female and 415 male township residents; mean age 33.2 years; +/- 10.1). All sera were tested for antibodies to KSHV lytic K8.1 and latent Orf73, HIV, gonococcus, herpes simplex virus type 2 (HSV-2), syphilis and chlamydia. Information on social, demographic and high-risk sexual behavior was linked to laboratory data, to evaluate risk factors, expressed as odds ratios (95% confidence interval) for KSHV. RESULTS Overall KSHV and HIV prevalences were 47.5 and 40%, respectively (P = 0.43). The risk of HIV infection was highest in sex workers then female residents and miners, compared with male residents (P < 0.001). HSV-2 infection was highly prevalent (66%) and lower, but still substantial, prevalences (6-8%) were observed for other sexually transmitted infections (STI). No significant difference in KSHV infection was observed among the residential groups (P > 0.05). KSHV was not associated with any of the STI or any measures of sexual behavior (P > 0.05). CONCLUSION The pattern of HIV and STI in sex workers suggests high rates of high-risk sexual behavior in this population. The lack of association with high-risk sexual behavior, particularly in sex workers, and with any markers of STI strongly suggest that the sexual mode does not play a significant role in KSHV transmission in this South African population.
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Giuliani M, Cordiali-Fei P, Castilletti C, Di Carlo A, Palamara G, Boros S, Rezza G. Incidence of human herpesvirus 8 (HHV-8) infection among HIV-uninfected individuals at high risk for sexually transmitted infections. BMC Infect Dis 2007; 7:143. [PMID: 18053246 PMCID: PMC2231363 DOI: 10.1186/1471-2334-7-143] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Accepted: 12/05/2007] [Indexed: 12/22/2022] Open
Abstract
Background The occurrence of, and risk factors for, HHV-8 infection have yet to be definitively determined, particularly among heterosexual individuals with at-risk behavior for sexually transmitted infections (STI). The objective of this study was to estimate the incidence and determinants of HHV-8 infection among HIV-uninfected individuals repeatedly attending an urban STI clinic. Methods Sera from consecutive HIV-uninfected individuals repeatedly tested for HIV-1 antibodies were additionally tested for HHV-8 antibodies using an immunofluorescence assay. To identify determinants of HHV-8 infection, a nested case-control study and multivariate logistic regression analysis were performed. Results Sera from 456 HIV-uninfected individuals (224 multiple-partner heterosexuals and 232 men who have sex with men (MSM]) were identified for inclusion in the study. The HHV-8 seroprevalence at enrollment was 9.4% (21/224; 95% C.I.: 6.0–14.2%) among heterosexuals with multiple partners and 22.0% (51/232; 95% C.I.: 16.9–28.0%) among MSM. Among the 203 multiple-partner heterosexuals and 181 MSM who were initially HHV-8-negative, 17 (IR = 3.0/100 p-y, 95% C.I.: 1.9 – 4.8) and 21 (IR = 3.3/100 p-y, 95% C.I:.2.1 – 5.1) seroconversions occurred, respectively. HHV-8 seroconversion tended to be associated with a high number of sexual partners during the follow-up among MSM (> 10 partners: AOR = 3.32 95% CI:0.89–12.46) and among the multiple-partner heterosexuals (> 10 partner; AOR = 3.46, 95% CI:0.42–28.2). Moreover, among MSM, HHV-8 seroconversion tended to be associated with STI (AOR = 1.80 95%CI: 0.52–7.96). During the study period the HIV-1 incidence was lower than that of HHV-8 among both groups (0.89/100 p-y among MSM and 0.95/100 p-y among multiple-partner heterosexuals). Conclusion The large difference between the incidence of HHV-8 and the incidence of HIV-1 and other STIs may suggest that the circulation of HHV-8 is sustained by practices other than classical at-risk sexual behavior.
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Affiliation(s)
- Massimo Giuliani
- Struttura Complessa di Dermatologia Infettiva, Istituto Dermatologico San Gallicano (IRCCS), Rome, Italy.
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Dibble SL, Eliason MJ, Christiansen MA. Chronic Illness Care for Lesbian, Gay, & Bisexual Individuals. Nurs Clin North Am 2007; 42:655-74; viii. [DOI: 10.1016/j.cnur.2007.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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