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Vanegas E, Thida AM, Heilman E, Preet M. Classic Kaposi Sarcoma in an Immunocompetent Male From Haiti: An Unusual Epidemiological Presentation. Cureus 2024; 16:e64518. [PMID: 39139306 PMCID: PMC11320912 DOI: 10.7759/cureus.64518] [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: 07/03/2024] [Accepted: 07/13/2024] [Indexed: 08/15/2024] Open
Abstract
Kaposi sarcoma (KS) is an angioproliferative disorder caused by human herpesvirus-8 (HHV-8) infection. KS manifests as vascular and mucosal nodules and is classified into four subtypes based on epidemiology, clinical presentation, histopathology, and HHV-8/human immunodeficiency virus serology. Here, we present a unique case of classic KS in an 84-year-old immunocompetent Haitian male patient, highlighting the rarity of this variant in this population. Additionally, our article delves into the broader context by reviewing a few documented cases of classic KS in the Caribbean region.
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Affiliation(s)
- Emanuel Vanegas
- Department of Internal Medicine, Woodhull Medical Center, New York, USA
| | - Aye M Thida
- Department of Hematology and Oncology, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - Edward Heilman
- Department of Dermatology and Pathology, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
| | - Mohan Preet
- Department of Hematology and Oncology, State University of New York (SUNY) Downstate Health Sciences University, New York, USA
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Lurain KA, Ramaswami R, Krug LT, Whitby D, Ziegelbauer JM, Wang HW, Yarchoan R. HIV-associated cancers and lymphoproliferative disorders caused by Kaposi sarcoma herpesvirus and Epstein-Barr virus. Clin Microbiol Rev 2024:e0002223. [PMID: 38899877 DOI: 10.1128/cmr.00022-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
SUMMARYWithin weeks of the first report of acquired immunodeficiency syndrome (AIDS) in 1981, it was observed that these patients often had Kaposi sarcoma (KS), a hitherto rarely seen skin tumor in the USA. It soon became apparent that AIDS was also associated with an increased incidence of high-grade lymphomas caused by Epstein-Barr virus (EBV). The association of AIDS with KS remained a mystery for more than a decade until Kaposi sarcoma-associated herpesvirus (KSHV) was discovered and found to be the cause of KS. KSHV was subsequently found to cause several other diseases associated with AIDS and human immunodeficiency virus (HIV) infection. People living with HIV/AIDS continue to have an increased incidence of certain cancers, and many of these cancers are caused by EBV and/or KSHV. In this review, we discuss the epidemiology, virology, pathogenesis, clinical manifestations, and treatment of cancers caused by EBV and KSHV in persons living with HIV.
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Affiliation(s)
- Kathryn A Lurain
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Ramya Ramaswami
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Laurie T Krug
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Joseph M Ziegelbauer
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Hao-Wei Wang
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert Yarchoan
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
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3
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Valcarcel-Valdivia B, Enriquez-Vera D, Piedra LE, Holguín A, De la Cruz Ku G. Treatment outcomes of patients with classic and AIDS-related Kaposi Sarcoma: a single-center real-world experience. Clin Exp Med 2023; 23:5463-5471. [PMID: 37940724 DOI: 10.1007/s10238-023-01246-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
The recommended first-line chemotherapy agents for managing Kaposi sarcoma (KS) in high-income countries are expensive and often unavailable in developing nations such as Peru. Limited data exist on whether management practices in these countries affect patient outcomes. We assessed the real-world treatment approaches and outcomes of patients with KS in Peru. We retrospectively reviewed the medical records of patients with acquired immunodeficiency syndrome-related KS (AIDS-related KS; n = 95) and classic KS (CKS; n = 81) diagnosed at a tertiary center between 2000 and 2014 in Lima, Peru. We used the Kaplan-Meier method to estimate overall survival (OS) rates. The median follow-up was 64 months for AIDS-related KS and 88 months for CKS. The median age of patients with AIDS-related KS was 35 years (range 20-63 years) and 70 years (range 33-91 years) for those with CKS. Most individuals had an Eastern Cooperative Oncology Group performance status of ≥ 2 (AIDS-related KS 75%; CKS 85%). Seventy-six percent and 40% of individuals with AIDS-related KS and CKS, respectively, received systemic chemotherapy. The most common first-line drug was paclitaxel, with relatively optimal overall response rates (ORRs) for AIDS-related KS (n = 64/72, 89%; ORR 61%) and CKS (n = 24/32, 75%; ORR 50%). The 5-year OS rates were 71% in the AIDS-related KS cohort and 81% in the CKS cohort. The findings from this real-world study may inform clinical practices and highlight the need for increased access to effective treatments and clinical trials for patients with KS in Peru and other developing countries.
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Affiliation(s)
- Bryan Valcarcel-Valdivia
- Cancer Research Networking, Universidad Científica del Sur, Lima, Peru
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | - Daniel Enriquez-Vera
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima, Peru
| | | | - Alexis Holguín
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Ibrahim Khalil A, Franceschi S, de Martel C, Bray F, Clifford GM. Burden of Kaposi sarcoma according to HIV status: A systematic review and global analysis. Int J Cancer 2022; 150:1948-1957. [PMID: 35085400 DOI: 10.1002/ijc.33951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/05/2022] [Accepted: 01/19/2022] [Indexed: 11/09/2022]
Abstract
In 2020, over 34 000 cases of Kaposi sarcoma (KS) were estimated globally, all attributable to KS herpesvirus (KSHV). Prior to the HIV epidemic, KS already existed in KSHV endemic regions, notably in sub-Saharan Africa (SSA). The HIV epidemic has vastly increased the KS burden. We developed a methodology to provide global estimates of KS burden according to HIV status. A systematic review identified studies reporting HIV prevalence in consecutive KS series. Pooled estimates of HIV prevalence, by country or UN subregion, were used to calculate population-attributable fraction (PAF) and these were applied to IARC's GLOBOCAN 2020 to estimate burden and incidence of HIV-attributable and non-HIV-attributable KS. We identified 55 eligible studies, reporting HIV prevalence ranging from ≤5% to ≥95%. Approximately 80% of KS in SSA was estimated attributable to HIV, vs ~50% in the rest of the world. By applying PAFs to national GLOBOCAN estimates, an estimated 19 560 KS cases attributable to HIV were diagnosed in SSA in 2020 (~80% of the worldwide burden), vs 5064 cases of non-HIV-attributable KS (~60% of the worldwide burden). Incidence of HIV-attributable KS was highest in Southern Africa (6.0 cases per 100 000) and Eastern Africa (3.4), which were also the world regions with highest incidence of non-HIV-attributable KS (0.4 and 1.0 cases per 100 000, respectively). This first systematic effort to produce a global picture of KS burden stratified by HIV status highlights the continuing important burden of HIV-attributable KS in SSA, even in the era of combined antiretroviral therapy.
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Affiliation(s)
- Ahmadaye Ibrahim Khalil
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Catherine de Martel
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Gary M Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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Lamoureux C, Drak Alsibai K, Pradinaud R, Sainte-Marie D, Couppie P, Blaizot R. Kaposi Sarcoma with Mucocutaneous Involvement in French Guiana: An Epidemiological Study between 1969 and 2019. Acta Derm Venereol 2022; 102:adv00709. [DOI: 10.2340/actadv.v102.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Data on Kaposi sarcoma in French Guiana are scarce and out of date. This territory presents unique epidemiological features. The objectives of this retrospective study were to analyse the clinical features, outcome and incidence of the different forms of Kaposi sarcoma in patients diagnosed between 1969 and 2019. The study population comprised a total of 52 patients. Clinical forms included epidemic Kaposi sarcoma (n=30), endemic (n=18), iatrogenic (n=2), classic (n=1) and unclassified Kaposi sarcoma (n=1). The mean annual incidence rate of epidemic Kaposi reached a peak in the 1990s (0.93/100,000) then decreased in the 2000s (0.33/100,000), while the incidence of endemic Kaposi sarcoma reached a peak in the 1980s (0.82/100,000) before decreasing in the 2000s (0.12/100,000). Factors associated with the epidemic form were: sexual intercourse between men (p=0.0054) and Haitian origin (p=0.035). The presence of nodules and/or tumour, lesions limited to the lower limbs, and age >65 years were associated with the endemic form. While Creole populations seem to be as affected by endemic Kaposi sarcoma as their African counterparts, the dynamics of Kaposi sarcoma in French Guiana are now dominated by the epidemic form.
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Zhou J, Shen X, Wang X, Xiao K, Cao Y, Jiang Y. Classic Kaposi sarcoma in a patient of Miao ethnicity followed up for 7 years: a case report. J Med Case Rep 2021; 15:179. [PMID: 33866974 PMCID: PMC8054400 DOI: 10.1186/s13256-021-02777-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Classic Kaposi sarcoma (CKS) is a vascular sarcoma associated with human herpesvirus 8 (HHV-8), which is known to be more common in Mediterranean elderly men and is characterized by indolent clinical behavior. Xinjiang province in China is considered an endemic region for Kaposi’s sarcoma-associated herpesvirus (KSHV), with higher incidence among adults of Kazak and Uyghur ethnicities. Cases of CKS are rarely reported in inland China. Here, we followed a case of CKS for 7 years in a patient of Miao ethnic background in southwestern China. Case presentation A 63-year-old Miao (southwestern China) man was initially diagnosed with CKS in 2010, having a history of limb lesions for 37 years, with left eyelid and binaural lesions for 9 years. He did not have sexual contact with men and was human immunodeficiency virus (HIV)-negative. Due to his lumbago and fever, spinal tuberculosis in the lumbar vertebra was highly suspected after computed tomography (CT) scan. However, diagnostic antituberculosis treatment for 4 weeks failed. The patient was followed up in 2016, when the rash was recovering as the systemic symptoms improved. A new CT was performed, which showed a partial response despite the absence of any medical treatment. The open reading frame (ORF)-K1 of KSHV from skin tissue of the foot was amplified and sequenced, and K1 belonged to subtype A. This genotype is consistent with the typical subtype present in Xinjiang. Conclusions We describe spontaneous partial regression of CKS in a patient of Miao ethnicity in inland China. Our sample may represent an unknown, novel genotype. Surveillance and regulating the immune state may represent a valuable approach for this rare disease.
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Affiliation(s)
- Jing Zhou
- Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China
| | - Xiaoping Shen
- Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China
| | - Xiaodong Wang
- Department of Dermatology, The Affiliated Hospital, XingJiang Medical University, Urumqi, China
| | - Kun Xiao
- Department of Radiology, Guiyang Third People's Hospital, Guiyang, China
| | - Yu Cao
- Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China
| | - Yanping Jiang
- Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China. .,Centre of Expertise in Mycology of RadboudUMC / CWZ, Nijmegen, The Netherlands.
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Gupta K, Tun A, Gupta A, Berkowitz LB, Anwar R, Liu Y, Guevara E. A case of classic Kaposi sarcoma in an immunocompetent human immunodeficiency virus-negative Dominican man. SAGE Open Med Case Rep 2020; 8:2050313X20938249. [PMID: 32670583 PMCID: PMC7339073 DOI: 10.1177/2050313x20938249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/03/2020] [Indexed: 12/14/2022] Open
Abstract
Kaposi sarcoma is an uncommon tumor that primarily arises in the skin and mucosal surfaces, but may metastasize to the internal organs. Four main variants of Kaposi sarcoma are recognized as the following: classic Kaposi sarcoma, which occurs in middle-aged or elderly men; epidemic Kaposi sarcoma, associated with human immunodeficiency virus infection; iatrogenic Kaposi sarcoma seen in patients on immunosuppressive drug therapy; and endemic Kaposi sarcoma. This report is of a case of classic Kaposi sarcoma in 55-year-old immunocompetent and human immunodeficiency virus-negative Dominican man who had lived in the United States for 2 years, who presented with a 2-year history of skin lesions on his lower extremities and soft palate. Biopsy of the soft palate was consistent with Kaposi sarcoma. The patient was treated with paclitaxel with a good response. This case report demonstrates the importance of recognizing that classic Kaposi sarcoma, first described almost 150 years ago, can still present in immunocompetent middle-aged men of all ethnicities.
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Affiliation(s)
- Kush Gupta
- Kasturba Medical College, Mangalore, Karnataka, India
| | - Aung Tun
- Hematology Oncology, The Brooklyn Hospital Center, New York, NY, USA
| | - Ashish Gupta
- Internal Medicine, The Brooklyn Hospital Center, New York, NY, USA
| | | | - Raheel Anwar
- Internal Medicine, The Brooklyn Hospital Center, New York, NY, USA
| | - Yingxian Liu
- Pathology, The Brooklyn Hospital Center, New York, NY, USA
| | - Elizabeth Guevara
- Hematology Oncology, The Brooklyn Hospital Center, New York, NY, USA
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8
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Demba RN, Shaviya N, Aradi SM, Mwanda W. Selected genes of Human herpesvirus-8 associated Kaposi's sarcoma among patients with Human Immunodeficiency Virus-1 and Acquired Immunodeficiency Disease Syndrome. Pan Afr Med J 2019; 32:215. [PMID: 31404285 PMCID: PMC6675582 DOI: 10.11604/pamj.2019.32.215.17322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 04/14/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Kaposi's sarcoma (KS) is a kind of cancer that causes flat or raised lesions containing Human herpes virus 8 (HHV8). The KS lesions are common among immunosuppressed HIV patients. Highly Active Antiretroviral (HHART) treats and prevents the development of KS. The objective of this study was to determine the presence of K1 and K15 (predominant alleles) genes in Kaposi's sarcoma-associated herpes virus (KSHV) among immunosuppressed patients due to HIV-1. METHODS This was a cross-sectional descriptive study where consecutive sampling technique was adopted to pick archived tissue blocks from the Thematic Unit of Anatomic Pathology, Department of Human Pathology, College of Health Sciences, University of Nairobi and Department of Laboratory Medicine, Histology Section, Kenyatta National Hospital. RESULTS Upon staining 81 tissue blocks with H & E, 84% (68/81) were diagnosed as KS and 16% (13/81) as KS-like. The K1 and K15 (P) genes were both detected at 88.9% (72/81) in the tissue blocks, with 95.8% (69/72) detection from KS and 4.2% (3/72) from the KS-like. CONCLUSION The K1 and K15 (P) genes of KSHV were present among the immunosuppressed patients with Human Immunodeficiency Virus (HIV)-1. It is important to carry out K1 and K15 (P) genes detection on tissues that are diagnosed as KS or KS-like by histology technique.
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Affiliation(s)
- Rodgers Norman Demba
- School of Health Sciences, Kisii University, Kisii, Kenya
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Nathan Shaviya
- Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | | | - Walter Mwanda
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
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Rivera-Castillo MP, Quispe-Pineda D, Lucchetti AJ. Letter to the editors regarding the paper: Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience. Infect Agent Cancer 2018; 13:39. [PMID: 30555526 PMCID: PMC6288895 DOI: 10.1186/s13027-018-0213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022] Open
Abstract
Non-Hodgkin Lymphoma (NHL) is a neoplasm associated with a group of malignancies called AIDs-Defining Malignancies (ADMs) in Human-Immunodeficiency Virus (HIV) -patients. Similar to the case of NHL in Latin America, particularly in Peru, the amount of research done on others ADMs is limited, especially in the case of Kaposi's Sarcoma (KS). Prior investigations have talked about the great potential risk that represents this illness in latin american population, but topics as prognosis factors are yet to be well defined. In this letter, we address the importance of investigation in this area and include previously reported data that may enlighten the current national standpoint.
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Affiliation(s)
- Mirtha P. Rivera-Castillo
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, 2 Alameda San Marcos Avenue, Chorrillos, 15067 Lima, Peru
| | - Diana Quispe-Pineda
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, 2 Alameda San Marcos Avenue, Chorrillos, 15067 Lima, Peru
| | - Aldo J. Lucchetti
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, 2 Alameda San Marcos Avenue, Chorrillos, 15067 Lima, Peru
- Servicio de Infectología, Hospital Nacional Arzobispo Loayza, 848 Alfonso Ugarte Avenue, Cercado de Lima, 15082 Lima, Peru
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Vangipuram R, Tyring SK. Epidemiology of Kaposi sarcoma: review and description of the nonepidemic variant. Int J Dermatol 2018; 58:538-542. [DOI: 10.1111/ijd.14080] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/10/2018] [Accepted: 05/16/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Ramya Vangipuram
- Department of Dermatology University of Texas Health Sciences Center at Houston Houston TX USA
- Center for Clinical Studies Houston TX USA
| | - Stephen K. Tyring
- Department of Dermatology University of Texas Health Sciences Center at Houston Houston TX USA
- Center for Clinical Studies Houston TX USA
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Purushothaman P, Uppal T, Sarkar R, Verma SC. KSHV-Mediated Angiogenesis in Tumor Progression. Viruses 2016; 8:E198. [PMID: 27447661 PMCID: PMC4974533 DOI: 10.3390/v8070198] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/18/2016] [Accepted: 07/07/2016] [Indexed: 12/14/2022] Open
Abstract
Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), is a malignant human oncovirus belonging to the gamma herpesvirus family. HHV-8 is closely linked to the pathogenesis of Kaposi's sarcoma (KS) and two other B-cell lymphoproliferative diseases: primary effusion lymphoma (PEL) and a plasmablastic variant of multicentric Castleman's disease (MCD). KS is an invasive tumor of endothelial cells most commonly found in untreated HIV-AIDS or immuno-compromised individuals. KS tumors are highly vascularized and have abnormal, excessive neo-angiogenesis, inflammation, and proliferation of infected endothelial cells. KSHV directly induces angiogenesis in an autocrine and paracrine fashion through a complex interplay of various viral and cellular pro-angiogenic and inflammatory factors. KS is believed to originate due to a combination of KSHV's efficient strategies for evading host immune systems and several pro-angiogenic and pro-inflammatory stimuli. In addition, KSHV infection of endothelial cells produces a wide array of viral oncoproteins with transforming capabilities that regulate multiple host-signaling pathways involved in the activation of angiogenesis. It is likely that the cellular-signaling pathways of angiogenesis and lymph-angiogenesis modulate the rate of tumorigenesis induction by KSHV. This review summarizes the current knowledge on regulating KSHV-mediated angiogenesis by integrating the findings reported thus far on the roles of host and viral genes in oncogenesis, recent developments in cell-culture/animal-model systems, and various anti-angiogenic therapies for treating KSHV-related lymphoproliferative disorders.
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Affiliation(s)
- Pravinkumar Purushothaman
- Department of Microbiology and Immunology, University of Nevada, Reno, School of Medicine, 1664 N Virginia Street, MS 320, Reno, NV 89557, USA.
| | - Timsy Uppal
- Department of Microbiology and Immunology, University of Nevada, Reno, School of Medicine, 1664 N Virginia Street, MS 320, Reno, NV 89557, USA.
| | - Roni Sarkar
- Department of Microbiology and Immunology, University of Nevada, Reno, School of Medicine, 1664 N Virginia Street, MS 320, Reno, NV 89557, USA.
| | - Subhash C Verma
- Department of Microbiology and Immunology, University of Nevada, Reno, School of Medicine, 1664 N Virginia Street, MS 320, Reno, NV 89557, USA.
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Trujillo JM, Alves NRDM, Medeiros PM, Azulay-Abulafia L, Alves MDFGS, Gripp AC. Clinical exuberance of classic Kaposi's sarcoma and response to radiotherapy. An Bras Dermatol 2016; 90:883-6. [PMID: 26734872 PMCID: PMC4689079 DOI: 10.1590/abd1806-4841.20153877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/11/2014] [Indexed: 11/21/2022] Open
Abstract
Kaposi's sarcoma (KS) is a multicentric vascular neoplasm, with cutaneous and
extracutaneous involvement. Different clinical and epidemiological variants
have been identified. The classic form is manifested mainly in elderly men
with indolent and long-term evolution, with lesions localized primarily in
the lower extremities. We present two cases of classic Kaposi's sarcoma
(CKS) in two female patients with extensive, exuberant skin involvement and
rapid evolution, with good response to radiotherapy.
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13
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Ferreira CP, Miranda A, Nery JADC. Kaposi's sarcoma simulating verrucous syndrome. Braz J Infect Dis 2015; 19:444-5. [PMID: 25989296 PMCID: PMC9427505 DOI: 10.1016/j.bjid.2015.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/05/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Cassio Porto Ferreira
- Ambulatório Souza Araújo, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
| | - Alice Miranda
- Ambulatório Souza Araújo, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - José Augusto da Costa Nery
- Ambulatório Souza Araújo, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
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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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15
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Alkharsah KR, Alzahrani AJ, Obeid OE, El-Harith EHA, Guella A, Mohamed EA, Haykal AH, Stuhrmann M, Al-Ali AK. Vascular endothelial growth factor A polymorphism and risk of Kaposi's sarcoma herpesvirus viremia in kidney allograft recipients. Transpl Infect Dis 2014; 16:783-9. [PMID: 25124076 DOI: 10.1111/tid.12277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 04/28/2014] [Accepted: 05/22/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Kaposi's sarcoma herpesvirus (KSHV) causes Kaposi's sarcoma (KS), primary effusion lymphoma, and multicentric Castleman's disease in immunocompromised patients including allograft recipients. Detection of KSHV DNA in blood, as well as host genetic polymorphisms has been found to be associated with an increased risk for KS. We investigated an association between single nucleotide polymorphisms (SNPs) in vascular endothelial growth factor A (VEGFA) gene region and KSHV viremia in kidney transplant recipients (KTR) in Saudi Arabia. METHODS In total, 152 KTR who have survived kidney transplantation for at least 6 months were included in the study. KSHV viremia was determined by real-time polymerase chain reaction (PCR). Genotyping of SNPs in the VEGFA region was performed by PCR and direct sequencing, as well as by restriction fragment length polymorphism. RESULTS KSHV DNA was detected in 28.9% (n = 44) of the study population. The A-allele at position C172A VEGFA gene promoter region was found to be associated with KSHV viremia (odd ratio [OR] = 4.8, P = 0.005). In addition, the G-allele at position C+405G in the 5'-untranslated region was associated with KSHV viremia in women, but not in men (OR = 3.98, P = 0.004). CONCLUSIONS Our results suggest an association of VEGFA polymorphisms with KSHV viremia among KTR in this study population. A limitation of our study is that the results can only be predicated for patients 6 months after kidney transplantation and should be validated in another cohort with larger sample size.
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Affiliation(s)
- K R Alkharsah
- Center for Research and Consultation Studies, University of Dammam, Dammam, Saudi Arabia
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Kourí V, Martínez PA, Capó V, Blanco O, Rodríguez ME, Jiménez N, Fleites G, Caballero I, Dovigny MC, Alemán Y, Correa C, Pérez L, Soto Y, Cardellá L, Álvarez A, Nambiar S, Hengge U. Kaposi’s Sarcoma and Human Herpesvirus 8 in Cuba: Evidence of subtype B expansion. Virology 2012; 432:361-9. [DOI: 10.1016/j.virol.2012.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 06/14/2012] [Accepted: 06/16/2012] [Indexed: 11/16/2022]
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Altunay I, Kucukunal A, Demirci GT, Ates B. Variable clinical presentations of Classic Kaposi Sarcoma in Turkish patients. J Dermatol Case Rep 2012; 6:8-13. [PMID: 22514583 PMCID: PMC3322103 DOI: 10.3315/jdcr.2012.1088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 11/11/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Kaposi sarcoma (KS) is a vascular neoplasm with multicentric cutanenous and extracutaneous involvements, which was first described by Moriz Kaposi in 1872. Since then, different epidemiological clinical and histopathological variants of this neoplasm have been identified. Classic Kaposi sarcoma (CKS) is one of four main clinico-epidemiologiologic variants. characteristics of the disease. MATERIALS AND METHODS Four Turkish inpatients with CKS were evaluated in the study. All medical history and clinical data were noted. A screening immunodeficiency workup were performed for all patients. HHV-8 immunofluorescence testing on the specimens and ELISA test for human immunodeficiency virus (HIV 1 and 2) were performed. Pulmonary X ray graphies and computurized tomography (CT) scan were applied. Stage of the tumor was determined, in each case, according to the classification system proposed by Brambilla et al in 2003. RESULTS All patients are positive for HHV-8. They were all immunocompetent and negative for HIV1 and HIV2. The first patient was unusual for morphological presentation of several verrucoid lesions that was evaluated as verrucoid KS. He was considered stage IB CKS. The patient 2 was a young man and the course of KS seemed unexpectedly aggressive for CKS. His clinical appearence seemed us to be a patient with AIDSassociated KS. The patient was evaluated as stage IVB CKS. Our third patient had also prominent lymphedema associated with bluish discoloration on the toes and fingers, suggesting a diagnosis of peripheral vascular disorder. He was diagnosed as stage IIIB CKS. The fourth case was interesting for very extensive lesions involving big sized plaques and also the existence of mucosal lesion. The patient was diagnosed as stage IVB CKS. CONCLUSIONS It seems that the reports of exceptional cases of KS are accumulating. Data from various cases should be collected and perhaps, novel clinical classifications should be considered.
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Affiliation(s)
| | - Asli Kucukunal
- Department of Dermatology, Sisli Etfal Training And Research Hospital, Istanbul, Turkey
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Basalely D, Khan KH, Cavazos GJ, D'Antoni AV, Bakotic BW. Pedal presentation of Kaposi's sarcoma in a non-HIV Hispanic female: a case report and literature review. J Foot Ankle Surg 2012; 51:365-8. [PMID: 22342112 DOI: 10.1053/j.jfas.2012.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Indexed: 02/03/2023]
Abstract
Kaposi's sarcoma is divided into 5 subtypes primarily differentiated by clinical presentation and typical at-risk population. We report the unique case of a 74-year-old Latin American woman who presented with a violaceous lesion on the dorsum of her right second digit, which was diagnosed as Kaposi's sarcoma but was not easily placed into a discrete subtype. We discuss the factors that usually predispose people to this infection and the lack of those factors in our patient, as well as the subsequent treatment of our patient. The patient remained in complete remission at 4 years follow-up.
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Jalilvand S, Tornesello ML, Buonaguro FM, Buonaguro L, Naraghi ZS, Shoja Z, Ziaee AA, Hamkar R, Shahmahmoodi S, Nategh R, Mokhtari-Azad T. Molecular epidemiology of human herpesvirus 8 variants in Kaposi's sarcoma from Iranian patients. Virus Res 2011; 163:644-9. [PMID: 21963664 DOI: 10.1016/j.virusres.2011.09.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 09/16/2011] [Accepted: 09/16/2011] [Indexed: 11/19/2022]
Abstract
Kaposi's sarcoma (KS) is a rare cancer in Iran and there is no epidemiological and molecular information about HHV-8 variants circulating among the Iranian population. In this study HHV-8 sequences have been analyzed in 43 cutaneous KS biopsies from Iranian patients mainly affected by classic KS. DNA samples were subjected to PCR amplification of HHV-8 ORF26, T0.7 and K1 followed by direct nucleotide sequencing and phylogenetic analysis. The analysis of ORF26 showed that 30 (69.8%) and 13 (30.2%) samples belonged to subtypes A/C and K, respectively. In general, the clustering of HHV-8 T0.7 variants paralleled that of ORF26. Genotyping of K1 sequences showed that the majority of samples (39 out of 41) fall into the large C clade with only 2 belonging to the A clade. In conclusion, HHV-8 variants identified among classic Iranian KS are largely related to Eurasian genotypes previously identified in KS from Mediterranean, Middle East, and East Asian regions.
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Affiliation(s)
- Somayeh Jalilvand
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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21
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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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22
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Classic Kaposi's sarcoma in Han Chinese and useful tools for differential diagnosis. Oral Oncol 2010; 46:654-6. [PMID: 20656545 DOI: 10.1016/j.oraloncology.2010.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 06/04/2010] [Accepted: 06/05/2010] [Indexed: 11/23/2022]
Abstract
Kaposi's sarcoma (KS) is a common AIDS-related malignant neoplasm in the head and neck region, especially in the oral cavity, but is rarely described in the HIV-negative and non-immunosuppressed individual. Our case is of interest, because it is the first case in which manifestation of the KS occurred in the face and head areas in a patient with a Han ethnic background who had an adequate immune system. The lesions were diagnosed as angiosarcomas twice. The clinical presentation, therapeutic options, and tools for differentiating Kaposi sarcoma from other vascular and nonvascular spindle cell lesions are presented, and the relevant literature is reviewed.
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Abstract
Abstract
Context.—Pseudoneoplastic cutaneous lesions are diverse, not only morphologically but also with respect to their causes and cellular lineages. They include proliferations of epithelial, as well as mesenchymal, elements.
Objective.—This review aims to consider selected lesions in the aforementioned groups, contrasting them with histologically similar neoplasms of the skin in a differential diagnostic setting.
Data Sources.—Information used in assembling this discussion was drawn from the published literature on cutaneous pseudoneoplasms, using an Internet-based search engine. The authors' collective experience was also used in writing this review.
Conclusions.—Sufficient clinical and morphologic differences exist in virtually all instances to separate pseudoneoplastic cutaneous proliferations from the tumors that they imitate.
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Affiliation(s)
- Mark R. Wick
- From the Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Charlottesville
| | - James W. Patterson
- From the Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Charlottesville
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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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25
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Coto Yglesias F, Chacón González K. [Kaposi's sarcoma: an unusual cause of persistent edema in an elderly woman]. Rev Esp Geriatr Gerontol 2010; 45:53-54. [PMID: 20044173 DOI: 10.1016/j.regg.2009.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 06/22/2009] [Accepted: 06/24/2009] [Indexed: 05/28/2023]
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Magri MC, Carbone PHL, de los Santos-Fortuna E, Caterino-de-Araujo A. A comparative study of the frequency of antibody and titers against human herpesvirus 8 latent and lytic antigens in “at-risk” individuals and among patients with Kaposi's sarcoma. J Med Virol 2009; 81:1292-7. [DOI: 10.1002/jmv.21513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Nascimento MC, Sumita LM, Souza VU, Weiss HA, Oliveira J, Mascheretti M, Quiroga M, Vela RAR, Sabino E, Pannuti CS, Mayaud P. Seroprevalence of Kaposi sarcoma-associated herpesvirus and other serologic markers in the Brazilian Amazon. Emerg Infect Dis 2009; 15:663-7. [PMID: 19331768 PMCID: PMC2671441 DOI: 10.3201/eid1504.081488] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To determine the presence of Kaposi sarcoma–associated herpesvirus (KSHV) and other serologic markers, we tested serum specimens of 339 Amerindians, 181 rural non-Amerindians, and 1,133 urban blood donors (13 Amerindians) in the Brazilian Amazon. High KSHV seroprevalence in children and inverse association with herpes simplex virus type 2 indicates predominant nonsexual transmission among Amerindians.
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Sampaio J, Brites C, Araujo I, Bacchi CE, Dittmer DP, Tanaka PY, Harrington W, Netto EM. AIDS related malignancies in Brazil. Curr Opin Oncol 2007; 19:476-8. [PMID: 17762574 PMCID: PMC2855639 DOI: 10.1097/cco.0b013e3282c8c8eb] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW There have been relatively few studies of HIV-related malignancies in Brazil. Universal access to antiretroviral drugs in Brazil has changed both the mortality and morbidity rates of AIDS. Nevertheless, there is also extreme poverty in both urban and rural areas and complications of prolonged immune suppression such as mycobacterial and malignant diseases have put a significant strain on the country's healthcare system. This brief review outlines the existing data regarding AIDS related malignancies in the largest Latin American country. RECENT FINDINGS Currently, there are almost 600 000 people infected with HIV in Brazil and 170,000 patients are receiving highly active antiretroviral therapy. In the studies done of HIV malignancies in Brazil, it appears that these tumors are histologically similar to those that occur in other equatorial countries and differ somewhat from those seen in Europe and the US. Another unique distinction is the high association with oncogenic herpes viruses. SUMMARY The existence of federally sponsored highly active antiretroviral therapy, clinicians and healthcare providers experienced in the care of HIV patients and high incidence of malignancies associated with oncogenic viruses make Brazil an important site for clinical and basic research in AIDS and immunodeficiency related malignancies.
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Affiliation(s)
- Julio Sampaio
- University of Miami Miller School of Medicine, Fogarty International Center (AIDS and Tuberculosis Program), Miami, Florida, USA
- Prof. Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil
| | - Carlos Brites
- Prof. Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil
| | - Iguaracyra Araujo
- Prof. Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil
| | | | - Dirk P. Dittmer
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Paula Y. Tanaka
- Section of Hematology, Emílio Ribas Infectology Institute, São Paulo, Brazil
| | - William Harrington
- University of Miami Miller School of Medicine, Fogarty International Center (AIDS and Tuberculosis Program), Miami, Florida, USA
| | - Eduardo M. Netto
- Prof. Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil
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Mohanna S, Portillo JA, Carriquiry G, Vidal J, Ferrufino JC, Sanchez J, Bravo F, Gotuzzo E. Human herpesvirus-8 in Peruvian blood donors: a population with hyperendemic disease? Clin Infect Dis 2007; 44:558-61. [PMID: 17243060 DOI: 10.1086/511044] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Accepted: 10/23/2006] [Indexed: 01/14/2023] Open
Abstract
Serum samples from 128 blood donors were tested for antibodies specific for human herpesvirus-8 by an immunofluorescence assay that detects antibodies against mainly lytic antigens. An overall seroprevalence of 56.25% was found (male donors, 54.68%; female donors, 57.11%). These findings indicate that human herpesvirus-8 infection is hyperendemic in Peruvian blood donors.
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Affiliation(s)
- Salim Mohanna
- Human Herpesvirus 8 and Classic Kaposi Sarcoma Working Group, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Duprez R, Cassar O, Hbid O, Rougier Y, Morisse L, Bassot S, Huerre M, Gessain A. Cutaneous disseminated endemic Kaposi's sarcoma in a Polynesian man infected with a new divergent human herpesvirus 8 subtype D. J Clin Virol 2006; 37:222-6. [PMID: 17011233 DOI: 10.1016/j.jcv.2006.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 06/22/2006] [Accepted: 07/08/2006] [Indexed: 11/28/2022]
Affiliation(s)
- Renan Duprez
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Institut Pasteur, Paris, France
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Kelloff GJ, Lippman SM, Dannenberg AJ, Sigman CC, Pearce HL, Reid BJ, Szabo E, Jordan VC, Spitz MR, Mills GB, Papadimitrakopoulou VA, Lotan R, Aggarwal BB, Bresalier RS, Kim J, Arun B, Lu KH, Thomas ME, Rhodes HE, Brewer MA, Follen M, Shin DM, Parnes HL, Siegfried JM, Evans AA, Blot WJ, Chow WH, Blount PL, Maley CC, Wang KK, Lam S, Lee JJ, Dubinett SM, Engstrom PF, Meyskens FL, O'Shaughnessy J, Hawk ET, Levin B, Nelson WG, Hong WK. Progress in chemoprevention drug development: the promise of molecular biomarkers for prevention of intraepithelial neoplasia and cancer--a plan to move forward. Clin Cancer Res 2006; 12:3661-97. [PMID: 16778094 DOI: 10.1158/1078-0432.ccr-06-1104] [Citation(s) in RCA: 218] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews progress in chemopreventive drug development, especially data and concepts that are new since the 2002 AACR report on treatment and prevention of intraepithelial neoplasia. Molecular biomarker expressions involved in mechanisms of carcinogenesis and genetic progression models of intraepithelial neoplasia are discussed and analyzed for how they can inform mechanism-based, molecularly targeted drug development as well as risk stratification, cohort selection, and end-point selection for clinical trials. We outline the concept of augmenting the risk, mechanistic, and disease data from histopathologic intraepithelial neoplasia assessments with molecular biomarker data. Updates of work in 10 clinical target organ sites include new data on molecular progression, significant completed trials, new agents of interest, and promising directions for future clinical studies. This overview concludes with strategies for accelerating chemopreventive drug development, such as integrating the best science into chemopreventive strategies and regulatory policy, providing incentives for industry to accelerate preventive drugs, fostering multisector cooperation in sharing clinical samples and data, and creating public-private partnerships to foster new regulatory policies and public education.
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Affiliation(s)
- Gary J Kelloff
- National Cancer Institute, Bethesda, Maryland 20852, USA.
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