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Silva-Santisteban A, Mahmood S, Fernandez WD, Rosenberg HJ, Dhorajiya P, Igbinedion S, Holzwanger E, Sawhney MS, Pleskow DK, Gabr M, Berzin TM. Gastrointestinal Kaposi Sarcoma: A Rare Case of an Isolated Rectal Lesion in an Immunocompetent HIV-Negative Patient. ACG Case Rep J 2023; 10:e01210. [PMID: 38130479 PMCID: PMC10735151 DOI: 10.14309/crj.0000000000001210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/20/2023] [Indexed: 12/23/2023] Open
Abstract
Kaposi sarcoma (KS) is a pathological endothelial growth associated with human herpes virus-8 which primarily affects the skin. In HIV-negative men who have sex with men, the clinical presentation of KS resembles the classic form limited to cutaneous or multifocal disease. In this report, we present a unique case of a healthy 61-year-old man who has sex with men with an isolated gastrointestinal KS who does not meet criteria for any of the typical KS clinical variants. Proper follow-up and regular HIV screenings are needed to evaluate the potential progression course of the disease in these patients.
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Affiliation(s)
- Andy Silva-Santisteban
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Sultan Mahmood
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Wilfor Diaz Fernandez
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Harry J. Rosenberg
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Poojaben Dhorajiya
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Samuel Igbinedion
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Erik Holzwanger
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Mandeep S. Sawhney
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Douglas K. Pleskow
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Moamen Gabr
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Tyler M. Berzin
- Center for Advanced Endoscopy, Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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Knights SM, Salyards M, Kendall N, Lazarte SM, Kainthla R, Miley W, Marshall V, Labo N, Whitby D, Chiao EY, Nijhawan AE. High Seroprevalence of Kaposi Sarcoma-Associated Herpesvirus in Men Who Have Sex With Men With HIV in the Southern United States. Open Forum Infect Dis 2023; 10:ofad160. [PMID: 37096147 PMCID: PMC10122490 DOI: 10.1093/ofid/ofad160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/15/2023] [Indexed: 04/26/2023] Open
Abstract
Background Disparities in mortality in human immunodeficiency virus (HIV)-associated Kaposi sarcoma have been described, particularly in Black men in the southern United States. It is unclear if there are racial/ethnic differences in the seroprevalence of Kaposi sarcoma-associated herpesvirus (KSHV) that may be contributing. Methods This is a cross-sectional study of men who have sex with men (MSM) and transgender women with HIV. Participants were recruited from an outpatient HIV clinic in Dallas, Texas, for a 1-time study visit and were excluded from analysis if they had any history of KSHV disease. Plasma was tested for antibodies to KSHV K8.1 or ORF73 antigens, and KSHV DNA was measured in oral fluids and blood by polymerase chain reaction. KSHV seroprevalence and viral shedding in blood and oral fluids were calculated. Additionally, independent risk factors for KSHV seropositivity were assessed by multivariable logistic regression analysis. Results Two hundred five participants were included in our analysis. Overall, KSHV seroprevalence was high (68%) with no significant difference between racial/ethnic groups. Among seropositive participants, KSHV DNA was detected in 28.6% of oral fluids and 10.9% of peripheral blood specimens, respectively. The factors most strongly associated with KSHV seropositivity were oral-anal sex (odds ratio [OR], 3.02), oral-penile sex (OR, 4.63), and methamphetamine use (OR, 4.67). Conclusions High local seroprevalence of KSHV is likely a key driver of the high burden of KSHV-associated diseases regionally, though it does not explain the observed disparities in KSHV-associated disease prevalence among racial/ethnic groups. Our findings support that KSHV is primarily transmitted via exchange of oral fluids.
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Affiliation(s)
- Sheena M Knights
- Correspondence: Sheena M. Knights, MD, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9113 (); Ank Nijhawan, MD, MPH, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9113 ()
| | - Maverick Salyards
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Noelle Kendall
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Physician Assistant Studies, Chapman University, Orange, California, USA
| | - Susana M Lazarte
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, Parkland Health, Dallas, Texas, USA
| | - Radhika Kainthla
- Department of Internal Medicine, Parkland Health, Dallas, Texas, USA
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Elizabeth Y Chiao
- Department of General Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ank E Nijhawan
- Correspondence: Sheena M. Knights, MD, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9113 (); Ank Nijhawan, MD, MPH, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9113 ()
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Seroprevalence and risk factors for Kaposi's Sarcoma associated herpesvirus among men who have sex with men in Shanghai, China. BMC Infect Dis 2023; 23:59. [PMID: 36721125 PMCID: PMC9887846 DOI: 10.1186/s12879-023-08028-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study aimed to facilitate the understanding of the transmission route and risk factors that might contribute to the infection of Kaposi's sarcoma associated herpesvirus (KSHV) among men who have sex with men (MSM). METHODS A cross-sectional study of 520 subjects was conducted in Shanghai, China in 2020. Plasma samples were collected and screened for KSHV, HIV, HBV, HCV, and syphilis. Univariate and multivariate logistic regression analyses were conducted to explore potential correlates of KSHV infection. RESULTS The overall seroprevalence of KSHV was 43.8%, with an adjusted value of 29.8% according to the sensitivity and specificity of the KSHV screening assay. Individuals with lower levels of monthly income (Chi-sqauretrend = 4.11, P = 0.043) and more male sex partners (Chi-sqauretrend = 6.06, P = 0.014) were more likely to be infected with KSHV. Also, KSHV seropositivity was positively associated with being a student (aOR = 1.96; 95%CI: 1.09-3.61), being coinfected with HCV (aOR = 2.61; 95%CI: 1.05-7.10), and syphilis (aOR = 2.91; 95%CI: 1.30-6.89). CONCLUSIONS The prevalence of KSHV in MSM remains high. As a risky sexual behavior, having multiple male sex partners is a key contributor to KSHV infection among this population. Efforts designed to control modifiable risk factors in order to reduce the burden of KSHV infection are indispensable. High KSHV seroprevalence among students MSM deserves more attention.
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Gothland A, Jary A, Grange P, Leducq V, Beauvais-Remigereau L, Dupin N, Marcelin AG, Calvez V. Harnessing Redox Disruption to Treat Human Herpesvirus 8 (HHV-8) Related Malignancies. Antioxidants (Basel) 2022; 12:antiox12010084. [PMID: 36670946 PMCID: PMC9854560 DOI: 10.3390/antiox12010084] [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: 11/24/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Reprogrammed metabolism is regarded as a hallmark of cancer and offers a selective advantage to tumor cells during carcinogenesis. The redox equilibrium is necessary for growth, spread and the antioxidant pathways are boosted following Reactive Oxygen Species (ROS) production to prevent cell damage in tumor cells. Human herpesvirus 8 (HHV-8), the etiologic agent of Kaposi sarcoma KS and primary effusion lymphoma (PEL), is an oncogenic virus that disrupts cell survival-related molecular signaling pathways leading to immune host evasion, cells growths, angiogenesis and inflammatory tumor-environment. We recently reported that primaquine diphosphate causes cell death by apoptosis in HHV-8 infected PEL cell lines in vivo and exhibits therapeutic anti-tumor activity in mice models and advanced KS. Our findings also suggest that the primaquine-induced apoptosis in PEL cells is mostly influenced by ROS production and targeting the redox balance could be a new approach to treat HHV-8 related diseases. In this review, we summarized the knowledge about the influence of ROS in cancer development; more specifically, the proof of evidence from our work and from the literature that redox pathways are important for the development of HHV-8 pathologies.
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Affiliation(s)
- Adélie Gothland
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Department of Virology, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
| | - Aude Jary
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Department of Virology, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
- Correspondence: (A.J.); (V.C.); Tel.: +33-1-42-17-74-01 (A.J.)
| | - Philippe Grange
- Cutaneous Biology Lab, INSERM U1016, UMR8104, Institut Cochin, Université de Paris, 24 Rue du Faubourg St Jacques, 75014 Paris, France
- Department of Dermatology, CeGGID et CNR IST Bactériennes, Hôpital Cochin Site Port Royale, AP-HP, Groupe Hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, 123 Boulevard de Port Royal, 75014 Paris, France
| | - Valentin Leducq
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Department of Virology, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
| | | | - Nicolas Dupin
- Cutaneous Biology Lab, INSERM U1016, UMR8104, Institut Cochin, Université de Paris, 24 Rue du Faubourg St Jacques, 75014 Paris, France
- Department of Dermatology, CeGGID et CNR IST Bactériennes, Hôpital Cochin Site Port Royale, AP-HP, Groupe Hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, 123 Boulevard de Port Royal, 75014 Paris, France
| | - Anne-Geneviève Marcelin
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Department of Virology, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
| | - Vincent Calvez
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Department of Virology, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013 Paris, France
- Correspondence: (A.J.); (V.C.); Tel.: +33-1-42-17-74-01 (A.J.)
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