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Alves CGB, Assis MS, Maciel ADS, da Silva JC, Leite-Ribeiro PM, Lins-Kusterer L, Sarmento VA. Clinical and Laboratory Profile of People Living with HIV/AIDS with Oral Kaposi Sarcoma. AIDS Res Hum Retroviruses 2021; 37:870-877. [PMID: 34538064 DOI: 10.1089/aid.2020.0311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The aim of this article was to evaluate the clinical and laboratory profile of people with oral Kaposi's sarcoma (KS) associated with AIDS (KS-AIDS), followed-up at a public university hospital in Salvador, Bahia, Brazil, in the past 10 years. We identified patients diagnosed with KS-AIDS, presenting oral manifestation from January 2007 to December 2017. We searched, in the hospital information systems, the patient demographics, diagnostic data, treatment, image studies, and oral photographic records. Of the 39 cases of KS-AIDS identified at the institution, 14 (22.8%) presented oral lesions. There was a predominance of black men, with a mean age of 32.5 years. Most cases (85.1%) manifested signs of KS simultaneously with the diagnosis of HIV infection, with extremely low initial CD4 T cell counts (average of 52.6 cells/mm2) and visceral involvement (64.3%). The palate (32.1%) and gingiva (21.4%) were the most affected oral sites. Histologically, the tumors exhibited proliferation of spindle cells between vascular clefts and extravasated erythrocytes. Oral KS-AIDS was frequent in young black adult men, with severe immunosuppression and high viral load counting, mostly with lesions manifested in the same period of diagnosis of infection by the HIV.
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Affiliation(s)
| | - Midian Sousa Assis
- Oral Care Department, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
- Propedeutics and Integrated Clinic Department, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | - Anderson da Silva Maciel
- Oral Care Department, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
- Propedeutics and Integrated Clinic Department, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | - Janaína Caribé da Silva
- Propedeutics and Integrated Clinic Department, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | - Patricia Miranda Leite-Ribeiro
- Oral Care Department, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
- Propedeutics and Integrated Clinic Department, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | - Liliane Lins-Kusterer
- Oral Care Department, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
- Department of Preventive and Social Medicine, School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Viviane Almeida Sarmento
- Oral Care Department, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
- Propedeutics and Integrated Clinic Department, School of Dentistry, Federal University of Bahia, Salvador, Brazil
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Shatokhin AI, Boichenko MN, Umbetov TZ, Pak SG, Volchkova EV. [Prevalence of DNA viruses in maxillofacial area of HIV-infected]. STOMATOLOGII︠A︡ 2018; 96:60-63. [PMID: 29260768 DOI: 10.17116/stomat201796660-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
DNA viruses have high oncogenic risk viruses; they cause emergence of Kaposi sarcoma, Lymphoma, Squamous cell carcinoma. HIV immunodeficiency promotes increase in frequency of such tumors. Etiotropic therapy of HIV patients considerably reduces prevalence of DNA viruses and a viral malignization.
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Affiliation(s)
- A I Shatokhin
- Moscow Regional HIV Center, Moscow, Russia; First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia
| | - M N Boichenko
- First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia
| | - T Zh Umbetov
- West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan
| | - S G Pak
- First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia
| | - E V Volchkova
- First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia
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3
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Bolanos R, Martinez-Maza O, Zhang ZF, Hussain S, Sehl M, Sinsheimer JS, D'Souza G, Jenkins F, Wolinsky S, Detels R. Decreased levels of the serum inflammatory biomarkers, sGP130, IL-6, sCRP and BAFF, are associated with increased likelihood of AIDS related Kaposi's sarcoma in men who have sex with men. ACTA ACUST UNITED AC 2018; 4:45-59. [PMID: 33521162 PMCID: PMC7845762 DOI: 10.17980/2018.45] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIDS-related Kaposi’s sarcoma (AIDS-KS) risk remains substantially elevated compared with the general population, even among patients who receive effective combination antiretroviral therapy. This study investigated the role of inflammatory and immune activating biomarkers in AIDS-KS in men who have sex with men in the Multicenter AIDS Cohort study between 1984 and 2010. Concentrations of 24 serum biomarkers; IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12p70, sGP130, sIL-2Rα, sIL-6R, eotaxin, MCP-1, MCP4, MIP 1β, TARC, BLC-BCA1, IP-10, GM-CSF, IFN-γ, BAFF, sCD14, CD27, sTNFR-2, sCRP, and TNF-α were tested longitudinally in 1,501 men. The concentrations of each biomarker were compared between AIDS-KS cases and controls at multiple time points, 0–1 years, 1–2 years, 2–3 year, 3–5 years and over 5 years, prior to KS diagnosis or study termination, using univariate non-parametric Kruskal-Wallis tests and logistic regression, adjusted for HBV and HCV co-infection, race/ethnicity, age at last visit, education, smoking and CD4+ cell count. In univariate analyses, concentrations of four markers were consistently higher in cases; sIL-2Rα, IP-10, sTNFR-2, MCP-1, and five were higher in controls; GM-CSF, IL-6, MIP-1β, sCRP, sGP130. In the adjusted models concentrations of four markers were significantly inversely associated with AIDS-KS risk including sGP130 (OR=0.14, 95% CI = 0.03–0.73, BAFF (OR=0.60, 95% CI =0.16–0.90), sCRP (OR=0.61, 95% CI = 0.43–0.87) and IL-6 (OR=0.51, 95% CI = 0.35–0.76). These results support a role for markers of immune activation and inflammation in AIDS-KS and may highlight pathways to be targeted for risk stratification or therapeutics.
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Affiliation(s)
- Rachel Bolanos
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA
| | - Otoniel Martinez-Maza
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA.,Departments of Obstetrics and Gynecology, and Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, UCLA, Los Angeles, CA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA.,UCLA AIDS Institute, UCLA, Los Angeles, CA
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA
| | - Shehnaz Hussain
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA.,Department of Medicine and Comprehensive Cancer Center, Cedars-Sinai Medical Center, West Hollywood, CA
| | - Mary Sehl
- Department of Medicine, Division of Hematology/Oncology, AIDS Institute, UCLA, Los Angeles, California.,Biomathematics, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Janet S Sinsheimer
- Department of Human Genetics, UCLA, Los Angeles, California.,Biomathematics, David Geffen School of Medicine, UCLA, Los Angeles, California.,Department of Biostatistics, School of Public Health, UCLA, Los Angeles, California
| | - Gypsyarn D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Frank Jenkins
- University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Steven Wolinsky
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago Illinois
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA
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Head and neck sarcomas: clinical and histopathological presentation, treatment modalities, and outcomes. J Laryngol Otol 2016; 130:850-9. [PMID: 27476336 DOI: 10.1017/s0022215116008604] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sarcoma of the head and neck is a rare condition that poses significant challenges in management and often requires radical multimodality treatment. OBJECTIVES This study aimed to analyse current clinical presentation, evaluation, management dilemmas and oncological outcomes. METHODS Computer records and case notes were analysed, and 39 patients were identified. Variables were compared using Pearson's chi-square test and the log-rank test, while survival outcomes were calculated using the Kaplan-Meier method. RESULTS The histopathological diagnosis was Kaposi sarcoma in 20.5 per cent of cases, chondrosarcoma in 15.3 per cent and osteosarcoma in 10.2 per cent. A range of other sarcomas were diagnosed in the remaining patients. The site of disease was most commonly sinonasal, followed by the oral cavity and larynx. CONCLUSION Wide local excision with clear resection margins is essential to achieve local control and long-term survival. There is a need for cross-specialty collaboration in order to accrue the evidence which will be necessary to improve long-term outcomes.
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Effect of Non-Hodgkin Lymphoma on Survival in Patients With Malignant Fibrous Histiocytoma, Kaposi Sarcoma, and Sebaceous Carcinoma: A SEER Population-Based Study. Dermatol Surg 2016; 42 Suppl 1:S32-9. [PMID: 26730972 DOI: 10.1097/dss.0000000000000520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To quantify the behavior of dermatofibrosarcoma protuberans (DFSP), malignant fibrous histiocytoma (MFH), Kaposi sarcoma (KS), and sebaceous carcinoma (SC) in patients with a history of non-Hodgkin lymphoma (NHL). PATIENTS AND METHODS Subjects with a diagnosis of DFSP, MFH, KS, or SC between 1990 and 2006 were identified in the Surveillance, Epidemiology, and End Results Program database. For each skin cancer type, the standardized mortality ratio (SMR) for death due to any cause and death due to skin cancer was estimated. RESULTS From 1990 through 2006, 25,357 skin cancers were identified: 4,192 DFSP, 6,412 MFH, 10,543 KS, and 4,222 SC. For patients with a history of non-CLL NHL, SMRs for death due to any cause were 1.45 (95% confidence interval [CI], 1.03-2.04; p = 0.04) for MFH, 2.90 (95% CI, 2.50-3.36; p < 0.001) for KS, and 3.25 (95% CI, 1.84-5.75; p < 0.001) for SC and SMRs for death due to skin cancer were 0.55 (95% CI, 0.23-1.31; p = 0.18) for MFH, 2.93 (95% CI, 2.49-3.43; p < 0.001) for KS, and 4.07 (95% CI, 1.28-12.94; p < 0.001) for SC. CONCLUSION Among patients with KS and SC, patients with a history of non-CLL NHL have a greater risk of overall and cause-specific death than expected.
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Valdés-Pineda S, Lara-Sánchez H, Torruco-García U, Dorantes-Heredia R. Síndrome inflamatorio de reconstitución inmune manifiesto como sarcoma de Kaposi en lengua. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2014; 65:123-5. [DOI: 10.1016/j.otorri.2012.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 07/06/2012] [Accepted: 07/10/2012] [Indexed: 11/15/2022]
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Valdés-Pineda S, Lara-Sánchez H, Torruco-García U, Dorantes-Heredia R. Immune Reconstitution Inflammatory Syndrome Manifested as a Kaposi's Sarcoma in the Tongue. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2014. [DOI: 10.1016/j.otoeng.2014.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Rapidis AD. Sarcomas of the head and neck in adult patients: current concepts and future perspectives. Expert Rev Anticancer Ther 2014; 8:1271-97. [DOI: 10.1586/14737140.8.8.1271] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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9
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Torretta S, Gaffuri M, Recalcati S, Marzano AV, Cantarella G, Iofrida E, Pignataro L. Pharyngolaryngeal location of Kaposi's sarcoma with airway obstruction in an HIV-negative patient. TUMORI JOURNAL 2013; 99:e208-10. [DOI: 10.1177/030089161309900514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Kaposi's sarcoma (KS) is a human herpes virus-8 (HHV-8)-associated angioproliferative disorder, and its occurrence may be favored by human immunodeficiency virus (HIV) infection and iatrogenic immunosuppression. It has also been postulated that a chronic inflammatory disease of the skin can pave the way to its development. KS generally involves mucosal and cutaneous sites, including the head and neck. An oropharyngeal location is quite common, but laryngeal involvement with possible upper airway obstruction and respiratory distress requiring tracheotomy is rare, and no hypopharyngeal locations have yet been reported. We describe the case of a 68-year-old male patient who developed KS after immunosuppressive treatment for pemphigus vulgaris, an autoimmune bullous disease presenting with blisters and erosions on the skin and the oral mucosa. KS was initially localized to the oral cavity and oropharynx, but subsequent involvement of the laryngeal and hypopharyngeal tract led to acute airway obstruction and the need for tracheotomy. This unique case of pharyngolaryngeal KS suggests that clinicians faced with purple nodular lesions should consider a differential diagnosis of KS in immunocompromised patients, even if they are HIV negative, and should carefully manage the patency of the upper airways.
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Affiliation(s)
- Sara Torretta
- Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Michele Gaffuri
- Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Sebastiano Recalcati
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | | | - Giovanna Cantarella
- Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Elisabetta Iofrida
- Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lorenzo Pignataro
- Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Benevenuto de Andrade BA, Ramírez-Amador V, Anaya-Saavedra G, Martínez-Mata G, Fonseca FP, Graner E, Paes de Almeida O. Expression of PROX-1 in oral Kaposi's sarcoma spindle cells. J Oral Pathol Med 2013; 43:132-6. [PMID: 23763431 DOI: 10.1111/jop.12097] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The histogenesis of neoplastic spindle cells of Kaposi's sarcoma is still uncertain, but some studies consider it a lymphatic vessel differentiation. Prox-1 is a nuclear transcription factor that plays a major role during embryonic lymphangiogenesis, and it has been considered a specific and sensitive lymphatic endothelial cell marker. The aim of this study was to determine the expression of Prox-1 in oral Kaposi's sarcoma comparing the results with oral benign vascular tumors including capillary hemangiomas and pyogenic granulomas. METHODS Expression of Prox-1 and HHV-8 was evaluated by immunohistochemistry in 30 oral Kaposi's sarcoma, 5 oral capillary hemangiomas, and 10 oral pyogenic granulomas. The labeling index was expressed as the percentage of positive cells for each case studied. Statistical comparison was performed using the Wilcoxon-Mann-Whitney rank sum test. RESULTS Twenty-eight (93.3%) and 30 oral Kaposi's sarcoma cases were positive for Prox-1 and HHV-8, respectively, while all oral benign vascular tumors were negative for these markers. The number of Prox-1 and HHV-8 oral Kaposi's sarcoma-positive cells increased significantly from patch/plaque to nodular histological stages. CONCLUSION The expression of Prox-1 in the neoplastic spindle cells supports the view of a lymphatic differentiation in oral Kaposi's sarcoma. Prox-1 may also be involved in the pathogenesis of oral Kaposi's sarcoma as the number of positive spindle cells increased progressively from patch to nodular stages and could be eventually useful as an additional diagnostic tool for differential diagnosis between oral Kaposi's sarcoma and benign oral vascular lesions.
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Affiliation(s)
- Bruno Augusto Benevenuto de Andrade
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Feller L, Essop R, Motswaledi MH, Khammissa RAG, Lemmer J. Advanced oral HIV-associated Kaposi sarcoma with facial lymphoedoema as an indicator of poor prognosis. S Afr Fam Pract (2004) 2012. [DOI: 10.1080/20786204.2012.10874290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- L Feller
- Department of Periodontology and Oral Medicine, School of Oral Health Sciences, Faculty of Health Sciences, University of Limpopo, Medunsa Campus
| | - R Essop
- Department of Periodontology and Oral Medicine, School of Oral Health Sciences, Faculty of Health Sciences, University of Limpopo, Medunsa Campus
| | - MH Motswaledi
- Department of Dermatology, Faculty of Health Sciences, University of Limpopo, Medunsa Campus
| | - RAG Khammissa
- Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus
| | - J Lemmer
- Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus
- Oral Medicine and Periodontology, University of Witwatersrand
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McLean AT, Wheeler EK, Cameron S, Baker D. HIV and dentistry in Australia: clinical and legal issues impacting on dental care. Aust Dent J 2012; 57:256-70. [PMID: 22924347 DOI: 10.1111/j.1834-7819.2012.01715.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- A T McLean
- St Vincent's Hospital, Fitzroy, Victoria, Australia
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13
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Pantanowitz L, Khammissa RAG, Lemmer J, Feller L. Oral HIV-associated Kaposi sarcoma. J Oral Pathol Med 2012; 42:201-7. [DOI: 10.1111/j.1600-0714.2012.01180.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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14
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Kaposi sarcoma: review and medical management update. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:2-16. [DOI: 10.1016/j.tripleo.2011.05.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 05/11/2011] [Accepted: 05/15/2011] [Indexed: 12/21/2022]
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15
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Pontes HAR, Guimarães DM, Pontes FSC, Paiva HB, Pinto LCD, de Freitas Silva BS, dos Santos Pinto D. Kaposi sarcoma and paracoccidioidomycosis in the same fragment of oral mucosa biopsy: a rare association in human immunodeficiency virus-positive patient. A case report. Diagn Microbiol Infect Dis 2011; 69:196-9. [DOI: 10.1016/j.diagmicrobio.2010.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 09/22/2010] [Accepted: 09/23/2010] [Indexed: 12/25/2022]
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Predictors of immune reconstitution inflammatory syndrome-associated with kaposi sarcoma in mozambique: a prospective study. J Acquir Immune Defic Syndr 2010; 53:589-97. [PMID: 19801945 DOI: 10.1097/qai.0b013e3181bc476f] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The impact and relevance of immune reconstitution inflammatory syndrome-associated with Kaposi sarcoma (IRIS-KS) has not been assessed in sub-Saharan African countries, where the bulk of HIV-1 and KS-associated herpesvirus (KSHV) coinfection occurs. Understanding the risk factors for developing IRIS-KS would aid in the identification and in the improvement of clinical management for high-risk patients. METHODS Sixty-nine consecutive HIV-1 and KSHV coinfected Mozambican adults initiating cART were prospectively followed for development of IRIS-KS over 10 months as part of a larger prospective observational study. Plasma HIV RNA, CD4 counts, anti-KSHV lytic antibodies, and plasma KSHV DNA viral load were assessed at the pre-cART visit and at 4 and 10 months after cART initiation. A survival analysis was performed to assess potential risk factors for developing IRIS-KS. RESULTS During the first 10 months of combined antiretroviral therapy (cART), 8 patients (8/69, 11.6%) experienced IRIS-KS at a median time of 13.8 weeks after cART initiation. Multivariate analysis identified 4 independent IRIS-KS predictors: clinical pretreatment KS [hazard ratio (HR) 91.7], detectable plasma KSHV DNA (HR 24.4), hematocrit <30% (HR 26.5), and plasma HIV-1 RNA viral load (HR 34.6 per log viral load increase). Treatment with either cART alone or with a combination of cART and systemic chemotherapy led to partial or complete clinical response in 62.5% (5/8) of IRIS-KS cases. CONCLUSIONS This study identified 4 independent predictors of IRIS-KS, which may help to develop screening tools aiding in the identification of patients at high risk of IRIS-KS for whom close clinical supervision is warranted.
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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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18
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Ramírez-Amador V, Martínez-Mata G, González-Ramírez I, Anaya-Saavedra G, De Almeida OP. Clinical, histological and immunohistochemical findings in oral Kaposi's sarcoma in a series of Mexican AIDS patients. Comparative study. J Oral Pathol Med 2009; 38:328-33. [DOI: 10.1111/j.1600-0714.2008.00740.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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19
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Wood NH, Feller L. The malignant potential of HIV-associated Kaposi sarcoma. Cancer Cell Int 2008; 8:14. [PMID: 18976452 PMCID: PMC2633277 DOI: 10.1186/1475-2867-8-14] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Accepted: 10/31/2008] [Indexed: 11/10/2022] Open
Abstract
Human herpesvirus (HHV)-8 associated oncogenesis, a state of immune impairment, a local inflammatory environment, angiogenesis and HIV infection occurring concurrently are important factors for the development of HIV-associated Kaposi sarcoma (KS). Activation of the interleukin (IL)-6 receptor signalling pathway and constitutive signalling of viral G protein-coupled receptor (vGPCR) play an important role in the activation, proliferation and transformation of HHV-8 infected endothelial cells thus contributing to the initiation and progression of KS. HIV-tat protein, HIV-induced immune suppression and a hyperinflammatory state facilitate the oncogenic activity of HHV-8. In this article we reviewed some aspects of HIV-KS pathogenesis and tried to establish, according to the available information in the literature, whether HIV-KS is a monoclonal neoplasm or a benign angioproliferative disorder. From the data of this review it is evident that most of the HIV-KS lesions are oligoclonal in origin. It remains to be demonstrated whether these multiple monoclonal populations of cells are neoplastic, harbouring specific cytogenetic alterations such as mutations, rearrangements and amplifications, or are, as the current evidence shows, the result of HHV-8 induced intracellular signalling pathways that modulate the expression of cellular genes associated with cell cycle regulation, apoptosis, inflammatory response and angiogenesis, and represent a reactive angioproliferative disorder.
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Affiliation(s)
- Neil H Wood
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Limpopo (Medunsa Campus) Pretoria, South Africa.
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Use of baculovirus-expressed glycoprotein H in an enzyme-linked immunosorbent assay developed to assess exposure to chelonid fibropapillomatosis-associated herpesvirus and its relationship to the prevalence of fibropapillomatosis in sea turtles. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2008; 15:843-51. [PMID: 18367581 DOI: 10.1128/cvi.00438-07] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Chelonid fibropapillomatosis-associated herpesvirus (CFPHV) is an alphaherpesvirus believed to cause marine turtle fibropapillomatosis (FP). A serodiagnostic assay was developed for monitoring sea turtle populations for CFPHV exposure. CFPHV glycoprotein H (gH) expressed in recombinant baculovirus was used in an enzyme-linked immunosorbent assay (ELISA) to detect virus-specific 7S turtle antibodies. Using captive-reared green turtles (Chelonia mydas) with no history of virus exposure as "known negatives" and others with experimentally induced FP as "known positives," the assay had 100% specificity but low sensitivity, as seroconversion was detected in only half of the turtles bearing experimentally induced tumors. Antibodies were detected only in samples collected after cutaneous fibropapillomas appeared, consistent with observations that tumors are significant sites of virion production and antigen expression and the possibility that prolonged/repeated virus shedding may be required for adequate stimulation of 7S antibody responses to gH. Natural routes of infection, however, may produce higher seroconversion rates. High gH antibody seroprevalences ( approximately 80%) were found among wild green turtles in three Florida localities with different FP prevalences, including one site with no history of FP. In addition, all eight loggerhead turtles (Caretta caretta) tested were seropositive despite FP being uncommon in this species. The possibility that CFPHV infection may be common relative to disease suggests roles for environmental and host factors as modulators of disease expression. Alternatively, the possibility of other antigenically similar herpesviruses present in wild populations cannot be excluded, although antibody cross-reactivity with the lung/eye/trachea disease-associated herpesvirus was ruled out in this study.
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Feller L, Masipa JN, Wood NH, Raubenheimer EJ, Lemmer J. The prognostic significance of facial lymphoedema in HIV-seropositive subjects with Kaposi sarcoma. AIDS Res Ther 2008; 5:2. [PMID: 18226270 PMCID: PMC2275292 DOI: 10.1186/1742-6405-5-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 01/29/2008] [Indexed: 11/10/2022] Open
Abstract
Background Kaposi Sarcoma (KS) is a multifocal angioproliferative neoplasm characterized by inflammation, oedema, neoangiogenesis and spindle cell proliferation. The pathogenesis of human immunodeficiency virus (HIV)-associated KS (HIV-KS) is multifactorial. HHV-8 is an essential factor but not in itself sufficient to cause HIV-KS, the development of which is influenced by HIV, by increased production of cytokines and by growth factors. Whether HIV-KS is a true malignancy or a reactive hyperplastic inflammatory condition is debatable. Results and Conclusion Oedema of the face, legs and hands is a prominent feature of HIV-KS and is probably caused by lymphoedema related to the HIV-KS lesions. The cases of two HIV-seropositive subjects with KS-associated facial lymphoedema are reported. Extensive oral HIV-KS in association with facial oedema in the absence of anti-retroviral treatment appears to be an indication of a poor prognosis.
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