1
|
Malonga GA, Jary A, Leducq V, Moudiongui Mboungou Malanda D, Boumba ALM, Chicaud E, Malet I, Calvez V, Peko JF, Marcelin AG. Seroprevalence and molecular diversity of Human Herpesvirus 8 among people living with HIV in Brazzaville, Congo. Sci Rep 2021; 11:17442. [PMID: 34465868 PMCID: PMC8408137 DOI: 10.1038/s41598-021-97070-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/19/2021] [Indexed: 12/30/2022] Open
Abstract
Human herpesvirus 8 (HHV8) is endemic in Africa, although studies of this infection are rare in Congo. We evaluated seroprevalence and HHV-8 diversity among people living with HIV. We included 353 patients receiving highly active antiretroviral therapy. Antibodies against HHV-8 latency-associated nuclear antigen were detected by indirect immunofluorescence. In HHV-8 positive patients, we performed HHV-8 quantification in blood and saliva by real-time PCR and typing by Sanger sequencing of K1 open reading frame. HHV-8 seroprevalence was 19%, being male (odd ratio [OR] = 1.741, [95% Confidence interval {CI}, 0.97-3.07]; p = 0.0581) and having multiple sex partners before HIV diagnosis (OR = 1.682, [CI 95%, 0.97-2.92]; p = 0.0629) tended to be associated with HHV-8 seropositivity. Of the 64 HHV-8 seropositive patients, HHV-8 DNA was detected in 10 (16%) in saliva, 6 (9%) in whole-blood and in 2 (3%) in both whole-blood and saliva. Three out of 6 HHV-8 strains were subtypes A5, 2 subtype B1 and 1 subtype C. HHV-8 seroprevalence was relatively low with more frequent carriage in men, associated with asymptomatic oral excretion and a predominance of subtype A5. These data tend to support the hypothesis of horizontal transmission in people living with HIV in Brazzaville.
Collapse
Affiliation(s)
- Gervillien Arnold Malonga
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France.
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo.
| | - Aude Jary
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Valentin Leducq
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Dimitry Moudiongui Mboungou Malanda
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire de Brazzaville, Brazzaville, Republic of Congo
| | - Anicet Luc Magloire Boumba
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo
- Laboratoire d'Analyses Médicales, Hôpital Général de Loandjili, Pointe-Noire, Republic of Congo
| | - Elodie Chicaud
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Isabelle Malet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Jean Felix Peko
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire de Brazzaville, Brazzaville, Republic of Congo
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| |
Collapse
|
2
|
Hulaniuk ML, Corach D, Trinks J, Caputo M. A simple and rapid approach for human herpesvirus type 8 subtype characterization using single base extension. Lett Appl Microbiol 2021; 73:308-317. [PMID: 34048079 DOI: 10.1111/lam.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/28/2022]
Abstract
Sequence analysis of the ORFK1 of human herpesvirus type 8 (HHV-8) allows the identification of six major subtypes (A-F), which are related to human migrations and the clinical progression of Kaposi's sarcoma. Sequencing and subsequent phylogenetic analysis of ORFK1 is considered to be the most reliable method for HHV-8 genotyping. However, it exhibits challenges and limitations. Herein, we designed and validated a single base extension (SBE) protocol for characterization of HHV-8 ORFK1 subtypes. A nested polymerase chain reaction (PCR) protocol was carried out to amplify a small 294-bp PCR product encompassing four single nucleotide polymorphisms at positions 360, 406, 465 and 527 of the HHV-8 genome. Finally, a multiplex SBE technique was developed and validated in 20 samples previously genotyped by phylogenetic analysis. The patterns obtained in this reaction could successfully discriminate between ORFK1 subtypes. The typing results obtained completely matched with those of the 'gold standard' method in all analysed samples. This method can reliably identify HHV-8 subtypes A, B and C, which are the most prevalent ones worldwide, and the remaining subtypes (D, E and F). SBE can be useful as an efficient, rapid and low-cost screening method for viral genotyping in a single tube, particularly samples with low-quality DNA, and with easy data interpretation.
Collapse
Affiliation(s)
- M L Hulaniuk
- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - D Corach
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética, Cátedra de Genética Forense y Servicio de Huellas Digitales Genéticas, Buenos Aires, Argentina
| | - J Trinks
- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano (HIBA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - M Caputo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética, Cátedra de Genética Forense y Servicio de Huellas Digitales Genéticas, Buenos Aires, Argentina
| |
Collapse
|
3
|
Epidemiology and Genetic Variability of HHV-8/KSHV among Rural Populations and Kaposi's Sarcoma Patients in Gabon, Central Africa. Review of the Geographical Distribution of HHV-8 K1 Genotypes in Africa. Viruses 2021; 13:v13020175. [PMID: 33503816 PMCID: PMC7911267 DOI: 10.3390/v13020175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/14/2022] Open
Abstract
Human herpesvirus 8 (HHV-8) is the etiological agent of all forms of Kaposi's sarcoma (KS). K1 gene studies have identified five major molecular genotypes with geographical clustering. This study described the epidemiology of HHV-8 and its molecular diversity in Gabon among Bantu and Pygmy adult rural populations and KS patients. Plasma antibodies against latency-associated nuclear antigens (LANA) were searched by indirect immunofluorescence. Buffy coat DNA samples were subjected to polymerase chain reaction (PCR) to obtain a K1 gene fragment. We studied 1020 persons; 91% were Bantus and 9% Pygmies. HHV-8 seroprevalence was 48.3% and 36.5% at the 1:40 and 1:160 dilution thresholds, respectively, although the seroprevalence of HHV-8 is probably higher in Gabon. These seroprevalences did not differ by sex, age, ethnicity or province. The detection rate of HHV-8 K1 sequence was 2.6% by PCR. Most of the 31 HHV-8 strains belonged to the B genotype (24), while the remaining clustered within the A5 subgroup (6) and one belonged to the F genotype. Additionally, we reviewed the K1 molecular diversity of published HHV-8 strains in Africa. This study demonstrated a high seroprevalence of HHV-8 in rural adult populations in Gabon and the presence of genetically diverse strains with B, A and also F genotypes.
Collapse
|
4
|
Hulaniuk ML, Mojsiejczuk L, Jauk F, Remondegui C, Mammana L, Bouzas MB, Zapiola I, Ferro MV, Ajalla C, Blejer J, Alter A, Acevedo ME, Rodríguez E, Fernández R, Bartoli S, Volonteri V, Kohan D, Elsner B, Bürgesser MV, Reynaud AL, Sánchez M, González C, García Rivello H, Corach D, Caputo M, Trinks J. Genetic diversity and phylogeographic analysis of human herpesvirus type 8 (HHV-8) in two distant regions of Argentina: Association with the genetic ancestry of the population. INFECTION GENETICS AND EVOLUTION 2020; 85:104523. [PMID: 32890766 DOI: 10.1016/j.meegid.2020.104523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The genetic diversity of persistent infectious agents, such as HHV-8, correlates closely with the migration of modern humans out of East Africa which makes them useful to trace human migrations. However, there is scarce data about the evolutionary history of HHV-8 particularly in multiethnic Latin American populations. OBJECTIVES The aims of this study were to characterize the genetic diversity and the phylogeography of HHV-8 in two distant geographic regions of Argentina, and to establish potential associations with pathogenic conditions and the genetic ancestry of the population. STUDY DESIGN A total of 101 HIV-1 infected subjects, 93 Kaposi's Sarcoma (KS) patients and 411 blood donors were recruited in the metropolitan (MET) and north-western regions of Argentina (NWA). HHV-8 DNA was detected by ORF-26 PCR in whole blood, saliva and FFPE tissues. Then, ORF-26 and ORF-K1 were analyzed for subtype assignment. Mitochondrial DNA and Y chromosome haplogroups, as well as autosomal ancestry markers were evaluated in samples in which subtypes could be assigned. Phylogeographic analysis was performed in the ORF-K1 sequences from this study combined with 388 GenBank sequences. RESULTS HHV-8 was detected in 50.7%, 59.2% and 8% of samples from HIV-1 infected subjects, KS patients and blood donors, respectively. ORF-K1 phylogenetic analyses showed that subtypes A (A1-A5), B1, C (C1-C3) and F were present in 46.9%, 6.25%, 43.75% and 3.1% of cases, respectively. Analyses of ORF-26 fragment revealed that 81.95% of strains were subtypes A/C followed by J, B2, R, and K. The prevalence of subtype J was more commonly observed among KS patients when compared to the other groups. Among KS patients, subtype A/C was more commonly detected in MET whereas subtype J was the most frequent in NWA. Subtypes A/C was significantly associated with Native American maternal haplogroups (p = 0.004), whereas subtype J was related to non-Native American haplogroups (p < 0.0001). Sub-Saharan Africa, Europe and Latin America were the most probable locations from where HHV-8 was introduced to Argentina. CONCLUSIONS These results give evidence of the geographic circulation of HHV-8 in Argentina, suggest the association of ORF-26 subtype J with KS development and provide new insights about its relationship with ancient and modern human migrations and identify the possible origins of this virus in Argentina.
Collapse
Affiliation(s)
- María Laura Hulaniuk
- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano (HIBA), Argentina
| | - Laura Mojsiejczuk
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - Federico Jauk
- Servicio de Anatomía Patológica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Remondegui
- Servicio de Infectología y Medicina Tropical, Hospital San Roque, San Salvador de Jujuy, Argentina
| | - Lilia Mammana
- Unidad de Virología - División Análisis Clínicos, Hospital de Infecciosas "F. J. Muñiz", Buenos Aires, Argentina
| | - María Belén Bouzas
- Unidad de Virología - División Análisis Clínicos, Hospital de Infecciosas "F. J. Muñiz", Buenos Aires, Argentina
| | - Inés Zapiola
- Unidad de Virología - División Análisis Clínicos, Hospital de Infecciosas "F. J. Muñiz", Buenos Aires, Argentina
| | - María Verónica Ferro
- Servicio de Infectología y Medicina Tropical, Hospital San Roque, San Salvador de Jujuy, Argentina
| | - Claudia Ajalla
- Servicio de Infectología y Medicina Tropical, Hospital San Roque, San Salvador de Jujuy, Argentina
| | | | - Adriana Alter
- Fundación Hemocentro Buenos Aires, Buenos Aires, Argentina
| | | | | | | | - Sonia Bartoli
- Servicio de Hemoterapia, Hospital "Pablo Soria", San Salvador de Jujuy, Argentina
| | - Victoria Volonteri
- Servicio de Anatomía Patológica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Dana Kohan
- Centro Privado de Patología, Buenos Aires, Argentina
| | - Boris Elsner
- Centro Privado de Patología, Buenos Aires, Argentina
| | | | - Ana Laura Reynaud
- Laboratorio de Patología y Citopatología, San Salvador de Jujuy, Argentina
| | - Marisa Sánchez
- Servicio de Infectología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos González
- Servicio de Hemoterapia, Hospital de Infecciosas "F. J. Muñiz", Buenos Aires, Argentina
| | - Hernán García Rivello
- Servicio de Anatomía Patológica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Corach
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética, Cátedra de Genética Forense y Servicio de Huellas Digitales Genéticas, Buenos Aires, Argentina
| | - Mariela Caputo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética, Cátedra de Genética Forense y Servicio de Huellas Digitales Genéticas, Buenos Aires, Argentina
| | - Julieta Trinks
- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), CONICET, Instituto Universitario del Hospital Italiano (IUHI), Hospital Italiano (HIBA), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.
| |
Collapse
|
5
|
Abounouh K, Aitraise I, Benabou A, Boussakri I, Doumir MA, El Boussairi C, El Idrissi S, El Mahdaoui C, Qouar DE, Ennahal A, Fathi S, Hafidi M, Lachker L, Ratib C, Tanouti IA, Maaroufi A, Benjelloun S, Guessous F, Pineau P, Ezzikouri S. Virus-associated human cancers in Moroccan population: From epidemiology to prospective research. INFECTION GENETICS AND EVOLUTION 2019; 75:103990. [PMID: 31386915 DOI: 10.1016/j.meegid.2019.103990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/25/2019] [Accepted: 08/02/2019] [Indexed: 12/24/2022]
Abstract
Eight human viruses have been classified by the International Agency for Research on Cancer as carcinogenic or probably carcinogenic for humans. Infection with high risk human papillomaviruses, hepatitis B and C viruses, Epstein-Barr virus (EBV), human T-Cell Lymphotropic Virus Type 1 (HTLV-1), Human herpesvirus 8 (HHV-8), Merkel cell polyomavirus and human immunodeficiency virus-1 (HIV1) alone or in combination with other agents are the main etiologic factors of many cancers. This review highlights some aspects of virus-associated human cancers, potentially responsible for >14,000 malignancies per year in Morocco. Given that not all individuals infected with these viruses develop cancer, somatic alterations, genetic predisposition, and lifestyle or environmental factors obviously play potentializing roles modulating viral activity. These viral, host genetic signatures and lifestyle interactions may represent a reservoir of biomarkers for early detection, prevention of cancer and rationale-based therapy.
Collapse
Affiliation(s)
- Karima Abounouh
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco; Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Imane Aitraise
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Anas Benabou
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | | | | | | | | | - Dalal El Qouar
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Afaf Ennahal
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Sofia Fathi
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Maria Hafidi
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Lamyae Lachker
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Chorouk Ratib
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | - Abderrahmane Maaroufi
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Soumaya Benjelloun
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Fadila Guessous
- Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Pascal Pineau
- Unité Organisation Nucléaire et Oncogenèse, INSERM U993, Institut Pasteur, Paris, France
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco.
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Etta EM, Alayande DP, Mavhandu-Ramarumo LG, Gachara G, Bessong PO. HHV-8 Seroprevalence and Genotype Distribution in Africa, 1998⁻2017: A Systematic Review. Viruses 2018; 10:E458. [PMID: 30150604 PMCID: PMC6164965 DOI: 10.3390/v10090458] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/31/2018] [Accepted: 08/02/2018] [Indexed: 12/13/2022] Open
Abstract
Human herpes virus type 8 (HHV-8) is the causative agent of Kaposi's sarcoma (KS). We systematically reviewed literature published between 1998 and 2017, according to the PRISMA guidelines, to understand the distribution of HHV-8 infection in Africa. More than two-thirds (64%) of studies reported on seroprevalence and 29.3% on genotypes; 9.5% were on both seroprevalence and genotypes. About 45% of African countries had data on HHV-8 seroprevalence exclusively, and more than half (53%) had data on either seroprevalence or genotypes. Almost half (47%) of the countries had no data on HHV-8 infection. There was high heterogeneity in the types of tests and interpretation algorithms used in determining HHV-8 seropositivity across the different studies. Generally, seroprevalence ranged from 2.0% in a group of young children in Eritrea to 100% in a small group of individuals with KS in Central African Republic, and in a larger group of individuals with KS in Morocco. Approximately 16% of studies reported on children. Difference in seroprevalence across the African regions was not significant (95% CI, χ² = 0.86; p = 0.35), although specifically a relatively significant level of infection was observed in HIV-infected children. About 38% of the countries had data on K1 genotypes. K1 genotypes A, A5, B, C, F and Z occurred at frequencies of 5.3%, 26.3%, 42.1%, 18.4%, 5.3% and 2.6%, respectively. Twenty-three percent of the countries had data for K15 genotypes, and genotypes P, M and N occurred at frequencies of 52.2%, 39.1%, and 8.7%, respectively. Data on HHV-8 inter-genotype recombinants in Africa are scanty. HHV-8 may be endemic in the entire Africa continent but there is need for a harmonized testing protocol for a better understanding of HHV-8 seropositivity. K1 genotypes A5 and B, and K15 genotypes P and M, from Africa, should be considered in vaccine design efforts.
Collapse
Affiliation(s)
- Elizabeth M Etta
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou 0950, South Africa.
| | - Doyinmola P Alayande
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou 0950, South Africa.
| | | | - George Gachara
- Department of Medical Laboratory Sciences, Kenyatta University, Nairobi 34556-00100, Kenya.
| | - Pascal O Bessong
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou 0950, South Africa.
| |
Collapse
|
8
|
Liu Z, Fang Q, Zuo J, Minhas V, Wood C, He N, Zhang T. Was Kaposi's sarcoma-associated herpesvirus introduced into China via the ancient Silk Road? An evolutionary perspective. Arch Virol 2017; 162:3061-3068. [PMID: 28687922 PMCID: PMC9937426 DOI: 10.1007/s00705-017-3467-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/20/2017] [Indexed: 02/04/2023]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) has become widely dispersed worldwide since it was first reported in 1994, but the seroprevalence of KSHV varies geographically. KSHV is relatively ubiquitous in Mediterranean areas and the Xinjiang Uygur Autonomous Region, China. The origin of KSHV has long been puzzling. In the present study, we collected and analysed 154 KSHV ORF-K1 sequences obtained from samples originating from Xinjiang, Italy, Greece, Iran and southern Siberia using Bayesian evolutionary analysis in BEAST to test the hypothesis that KSHV was introduced into Xinjiang via the ancient Silk Road. According to the phylogenetic analysis, 72 sequences were subtype A and 82 subtype C, with C2 (n = 56) being the predominant subtype. The times to the most recent common ancestors (tMRCAs) of KSHV were 29,872 years (95% highest probability density [HPD], 26,851-32,760 years) for all analysed sequences and 2037 years (95% HPD, 1843-2229 years) for Xinjiang sequences in particular. The tMRCA of Xinjiang KSHV was exactly matched with the time period of the ancient Silk Road approximately two thousand years ago. This route began in Chang'an, the capital of the Han dynasty of China, and crossed Central Asia, ending in the Roman Empire. The evolution rate of KSHV was slow, with 3.44 × 10-6 substitutions per site per year (95% HPD, 2.26 × 10-6 to 4.71 × 10-6), although 11 codons were discovered to be under positive selection pressure. The geographic distances from Italy to Iran and Xinjiang are more than 4000 and 7000 kilometres, respectively, but no explicit relationship between genetic distance and geographic distance was detected.
Collapse
Affiliation(s)
- 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, 200032, China
| | - Qiwen Fang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, 200032, China
| | - Jialu Zuo
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, Shanghai, 200032, China
| | - Veenu Minhas
- School of Biological Sciences, Nebraska Center of Virology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Charles Wood
- School of Biological Sciences, Nebraska Center of Virology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - 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, 200032, China
| | - 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, 200032, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
| |
Collapse
|
9
|
Pérez CL, Tous MI. Diversity of human herpesvirus 8 genotypes in patients with AIDS and non-AIDS associated Kaposi's sarcoma, Castleman's disease and primary effusion lymphoma in Argentina. J Med Virol 2017; 89:2020-2028. [PMID: 28617968 DOI: 10.1002/jmv.24876] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 06/08/2017] [Indexed: 11/09/2022]
Abstract
HHV-8 genotypes are distributed heterogeneously worldwide. The variable K1 gene and the conserved ORF26E region serve to genotype. The aim of the study was to characterize HHV-8 isolates from patients with AIDS, classical, and iatrogenic KS, primary effusion lymphoma and Castleman's disease and one organ donor from Argentina by analysis of ORFK1 and ORF26E regions. DNA was extracted from fresh or paraffin embedded biopsies, blood, and saliva samples and submitted to HHV-8 PCR. Phylogenetic analyses of ORFK1 showed that subtypes C (C1, C2, and C3), B1 and A (A1, A2, and A3) were present in 70.8%, 16.7%, and 12.5% of cases, respectively. Analyses of ORF26E fragment revealed that most strains (45.8%) were subtype A/C while the remaining fall into K, J, B2, R, and D subtypes. Linkage between ORFK1-ORF26E subtypes corresponded to reported relationships, except for one strain that clustered with B1 (K1 African) and D (ORF26E Asian-Pacific) subtypes. This research reveals predominance of subtype C, a broad spectrum of HHV-8 genotypes and reports the first isolation of the African B genotype in Argentina.
Collapse
Affiliation(s)
- Celeste Luján Pérez
- Tissue Culture Service Virology Department INEI-ANLIS "Dr C G Malbrán", Buenos Aires, Argentina
| | - Mónica I Tous
- Tissue Culture Service Virology Department INEI-ANLIS "Dr C G Malbrán", Buenos Aires, Argentina
| |
Collapse
|
10
|
Varmazyar S, Shoja Z, Kakavand-Ghalehnoei R, Shahmahmoodi S, Marashi SM, Jalilvand S. Molecular typing of human herpesvirus 8 among HIV positive in comparison to HIV-negative individuals in Iran. J Med Virol 2016; 89:703-709. [PMID: 27463857 DOI: 10.1002/jmv.24644] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 01/19/2023]
Abstract
It is still unclear whether different HHV-8 genotypes may have different pathogenic and tumorigenic properties associated with a diverse rate of disease progression. In some areas where genotype C was found to be prominent among classic KS patients, genotype A was shown to be more frequent among AIDS-associated KS patients. Genotype C was previously reported to be widespread in Iran, with genotype A being less frequent among patients with classic KS although no data are available with regards to the HHV-8 genotyping among Iranian HIV-infected patients. In order to analyze HHV-8 genotypes (ORF K1), six HIV-infected patients (with or without KS), and 22 HIV-negative subjects (classic/iatrogenic KS patients and IVDUs) were investigated using nested PCR. Genotype A was detected more frequently among HIV-infected patients with or without KS (three out of six) whereas genotype C was found more common among HIV-negative subjects including classic/iatrogenic KS patients and IVDSs (21 out of 22), and this difference was statistically significant (P = 0.044). In conclusion, our data further support the dominancy of HHV-8 genotype C in Iranian general population. Moreover, genotype A was more common among HIV-infected patients with or without KS. J. Med. Virol. 89:703-709, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Sajad Varmazyar
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Shohreh Shahmahmoodi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed Mahdi Marashi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Tozetto-Mendoza TR, Ibrahim KY, Tateno AF, de Oliveira CM, Sumita LM, Sanchez MCA, Luna EJ, Pierrotti LC, Drexler JF, Braz-Silva PH, Pannuti CS, Romano CM. Genotypic distribution of HHV-8 in AIDS individuals without and with Kaposi sarcoma: Is genotype B associated with better prognosis of AIDS-KS? Medicine (Baltimore) 2016; 95:e5291. [PMID: 27902590 PMCID: PMC5134807 DOI: 10.1097/md.0000000000005291] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIDS-associated Kaposi's sarcoma (AIDS-KS) caused by human herpes virus 8 (HHV-8) is the most severe and resistant form of KS tumor. Our aim was to verify whether there is an association between HHV-8 variability and development of AIDS-KS in Brazil by comparing the HHV-8 variability between individuals without and with KS. Saliva samples and blood, when available, were analyzed by polymerase chain reaction (PCR) techniques for detection of the fragments of ORF K1 of HHV-8, which were then genotyped and analyzed regarding the genetic variability. Our study described 106 positive cases for HHV-8 in the saliva from 751 AIDS patients without previous KS. In addition, we performed a phylogenetic analysis of HHV-8 in 34 of the 106 AIDS patients without KS and in 33 of the 37 patients with active KS. The distribution of HHV-8 genotypes A, B, C, and F in AIDS individuals was indistinguishable by comparing non-KS and KS groups, as well as regarding ethnicity. Considering the KS group, genotype B was associated with better prognosis of KS tumor. Interestingly, we found a particular profile of diversity within clade C and 2 recombinant patterns of HHV-8 in the saliva of AIDS individuals without KS. We emphasize the need to achieve standard genotyping protocol for ORF K1 amplification, thus allowing for substantial detection of HHV-8 variants. Our findings can shed light on the role of HHV-8 variability in the pathogenesis of AIDS-KS.
Collapse
Affiliation(s)
| | - Karim Yaqub Ibrahim
- Department of Infectious Diseases, Clinics Hospital of the School of Medicine
| | - Adriana Fumie Tateno
- Institute of Tropical Medicine Laboratory of Virology LIM52
- Institute of Virology, University of Bonn Medical Centre, Bonn, German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Germany
| | | | | | | | | | | | - Jan Felix Drexler
- Institute of Virology, University of Bonn Medical Centre, Bonn, German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Germany
| | - Paulo Henrique Braz-Silva
- Institute of Tropical Medicine Laboratory of Virology LIM52
- Pathology Department of the School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | |
Collapse
|
12
|
Betsem E, Cassar O, Afonso PV, Fontanet A, Froment A, Gessain A. Epidemiology and genetic variability of HHV-8/KSHV in Pygmy and Bantu populations in Cameroon. PLoS Negl Trop Dis 2014; 8:e2851. [PMID: 24831295 PMCID: PMC4022623 DOI: 10.1371/journal.pntd.0002851] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 03/27/2014] [Indexed: 11/19/2022] Open
Abstract
Background Kaposi's sarcoma associated herpesvirus (KSHV/HHV-8) is the causal agent of all forms of Kaposi sarcoma. Molecular epidemiology of the variable K1 region identified five major subtypes exhibiting a clear geographical clustering. The present study is designed to gain new insights into the KSHV epidemiology and genetic diversity in Cameroon. Methodology/Principal Findings Bantu and Pygmy populations from remote rural villages were studied. Antibodies directed against latent nuclear antigens (LANA) were detected by indirect immunofluorescence using BC3 cells. Peripheral blood cell DNAs were subjected to a nested PCR amplifying a 737 bp K1 gene fragment. Consensus sequences were phylogenetically analyzed. We studied 2,063 persons (967 females, 1,096 males, mean age 39 years), either Bantus (1,276) or Pygmies (787). The Bantu group was older (42 versus 35 years: P<10−4). KSHV anti-LANA seroprevalence was of 37.2% (768/2063), with a significant increase with age (P<10−4) but no difference according to sex. Seroprevalence, as well as the anti-LANA antibodies titres, were higher in Bantus (43.2%) than in Pygmies (27.6%) (P<10−4), independently of age. We generated 29 K1 sequences, comprising 24 Bantus and five Pygmies. These sequences belonged to A5 (24 cases) or B (five cases) subtypes. They exhibited neither geographical nor ethnic aggregation. A5 strains showed a wide genetic diversity while the B strains were more homogenous and belonged to the B1 subgroup. Conclusion These data demonstrate high KSHV seroprevalence in the two major populations living in Southern and Eastern Cameroon with presence of mostly genetically diverse A5 but also B K1 subtypes. Kaposi's sarcoma associated herpesvirus (KSHV/HHV-8) is the causal agent of one of the most frequent skin tumors found endemically or epidemically associated to HIV in Central and Eastern Africa. This highly variable virus tends to cluster geographically according to specific major subtypes. Its prevalence is high in that area and increases with age. Despite its association to all forms of Kaposi sarcoma and high prevalence described in some low income populations in Cameroon, KSHV arouses limited interest, and only few focused previous studies have looked into prevalence and modes of transmission, especially in families. Extended molecular epidemiology is unknown both in healthy individuals and in Kaposi patients, which led to looking for new insights among Bantu and Pygmy populations from rural villages in three regions of Cameroon sharing a quite similar living environment but yet genetically, socially, and culturally different. The present study is designed to describe variations of molecular subtypes in each of these population groups regarding their geography in rural areas of southern, central, and eastern Cameroon.
Collapse
Affiliation(s)
- Edouard Betsem
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France
- CNRS, UMR3569, Paris, France
- Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Olivier Cassar
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France
- CNRS, UMR3569, Paris, France
| | - Philippe V. Afonso
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France
- CNRS, UMR3569, Paris, France
| | - Arnaud Fontanet
- Institut Pasteur, Unité de Recherche et d'Expertise Epidémiologie des Maladies Emergentes, Département Infection et Epidémiologie, Paris, France
- Conservatoire National des Arts et Métiers, Paris, France
| | - Alain Froment
- Institut de Recherche pour le Développement, Musée de l'Homme, Place du Trocadéro, Paris, France
| | - Antoine Gessain
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France
- CNRS, UMR3569, Paris, France
- * E-mail:
| |
Collapse
|
13
|
Leao JC, de Faria ABS, Fonseca DDD, Gueiros LAM, Silva IHM, Porter SR. Intrahost genetic variability of human herpes virus-8. J Med Virol 2013; 85:636-45. [DOI: 10.1002/jmv.23491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2012] [Indexed: 01/19/2023]
|
14
|
Matteoli B, Broccolo F, Scaccino A, Cottoni F, Angeloni A, Faggioni A, Ceccherini-Nelli L. In vivo and in vitro evidence for an association between the route-specific transmission of HHV-8 and the virus genotype. J Med Virol 2012; 84:786-91. [PMID: 22431027 DOI: 10.1002/jmv.23246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The study was performed to determine if there is an association between the genotype and transmission of HHV-8 types A and C. These HHV-8 subtypes are prevalent in the area of North of Sardinia, which is an island off west Italy's mainland that has a high HHV-8 seroprevalence (35%). Blood and saliva samples from 30 patients with classic Kaposi's sarcoma who were lifetime residents of North Sardinia were analyzed to identify the HHV-8 genotype and quantitate the viral load. Genotype A, especially A1 subtype, was found more frequently (9/30 patients) and had a significantly higher viral load in saliva compared to blood (P = 0.029), where type C was found more frequently but with a viral load lower than 10(3) copies/ml. To determine if there is a correlation between the viral genotype and cellular tropism, type A1 and C3 HHV-8 viral particles were obtained from cell lines BCBL1 and BC3 infected chronically with HHV-8 A1 and C3 genotypes respectively and used to infect HEK293 epithelial origin cells and PBMCs in vitro. The data indicate that the A1 HHV-8 genotype is tropic and replicates at higher levels in the epithelial cell lines.
Collapse
Affiliation(s)
- Barbara Matteoli
- Virology Unit, Pisa University Hospital (Azienda Ospedaliero-Universitaria Pisana), Pisa, Italy
| | | | | | | | | | | | | |
Collapse
|
15
|
Genetic variability and integration of Merkel cell polyomavirus in Merkel cell carcinoma. Virology 2012; 426:134-42. [PMID: 22342276 DOI: 10.1016/j.virol.2012.01.018] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 10/28/2011] [Accepted: 01/19/2012] [Indexed: 11/22/2022]
Abstract
Merkel cell polyomavirus (MCPyV) is associated to Merkel cell carcinoma (MCC). We studied 113 MCC tumoral skin lesions originating from 97 patients. MCPyV detection was higher in fresh-frozen (FF) biopsies (94%) than in formalin-fixed paraffin-embedded biopsies (39-47%). Mean viral load in FF tumor was of 7.5 copies per cell with a very wide range (0.01-95.4). Nineteen complete sequences of LTAg were obtained, mainly from FF biopsies when the viral load was high. Seventeen showed stop codons, all localized downstream of the pRb protein binding domain. Sequence comparison and phylogenetic analysis showed that all sequences clustered in the large C clade of MCPyV strains. MCPyV integration was demonstrated in 19 out of 27 FF MCC DNA biopsies without evidence of specific host cellular genome integration site. In 13/19 cases, the viral junction was located within the second exon of the LTAg, after the pRB binding domain.
Collapse
|
16
|
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.
Collapse
Affiliation(s)
- Somayeh Jalilvand
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Ramos da Silva S, Ferraz da Silva AP, Bacchi MM, Bacchi CE, Elgui de Oliveira D. KSHV genotypes A and C are more frequent in Kaposi sarcoma lesions from Brazilian patients with and without HIV infection, respectively. Cancer Lett 2011; 301:85-94. [DOI: 10.1016/j.canlet.2010.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 10/09/2010] [Accepted: 10/13/2010] [Indexed: 10/18/2022]
|
18
|
Human herpesvirus 8 infections in patients with immunodeficiencies. Hum Pathol 2008; 39:983-93. [DOI: 10.1016/j.humpath.2008.02.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 02/12/2008] [Accepted: 02/18/2008] [Indexed: 12/30/2022]
|