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Human herpesvirus 8 and Kaposi sarcoma: how should we screen and manage the transplant recipient? Curr Opin Infect Dis 2021; 34:646-653. [PMID: 34693921 DOI: 10.1097/qco.0000000000000792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW HHV-8-associated diseases are rare but potentially fatal in transplant recipients. Important differences exist in the distribution of HHV-8 seroprevalence, which might contribute to the lack of uniform approach to HHV-8. The aim of this review was to discuss recent updates in screening and management of HHV-8 after transplant. RECENT FINDINGS Increasing attention has been given to the nonmalignant but potentially fatal inflammatory syndrome caused by HHV-8 in solid organ transplant (SOT) recipients. At-risk groups include HHV-8-IgG D+/R- transplant and HHV-8-positive recipients. Severe cases of donor-derived HHV-8 disease, mainly Kaposi sarcoma, frequently without skin involvement and some diagnosed at autopsy, highlight the need to increase clinicians' awareness, to implement effective preemptive strategies and to perform rapid diagnosis. In HSCT setting, HHV-8-associated disorders are very rare. SUMMARY Identification of SOT recipients at risk through reliable serology is warranted and the utility of preemptive management and HHV-8-DNA monitoring should be studied. Clinicians should be aware of severe nonmalignant disorders and of early post-SOT Kaposi sarcoma cases with lymph node or transplanted organ involvement in order to provide prompt diagnosis and treatment. No screening for HHV-8 is warranted after HSCT but rapid diagnosis and reduction of immunosuppression remain fundamental.
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Chabay P, Lens D, Hassan R, Rodríguez Pinilla SM, Valvert Gamboa F, Rivera I, Huamán Garaicoa F, Ranuncolo SM, Barrionuevo C, Morales Sánchez A, Scholl V, De Matteo E, Preciado MV, Fuentes-Pananá EM. Lymphotropic Viruses EBV, KSHV and HTLV in Latin America: Epidemiology and Associated Malignancies. A Literature-Based Study by the RIAL-CYTED. Cancers (Basel) 2020; 12:E2166. [PMID: 32759793 PMCID: PMC7464376 DOI: 10.3390/cancers12082166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 02/06/2023] Open
Abstract
The Epstein-Barr virus (EBV), Kaposi sarcoma herpesvirus (KSHV) and human T-lymphotropic virus (HTLV-1) are lymphomagenic viruses with region-specific induced morbidity. The RIAL-CYTED aims to increase the knowledge of lymphoma in Latin America (LA), and, as such, we systematically analyzed the literature to better understand our risk for virus-induced lymphoma. We observed that high endemicity regions for certain lymphomas, e.g., Mexico and Peru, have a high incidence of EBV-positive lymphomas of T/NK cell origin. Peru also carries the highest frequency of EBV-positive classical Hodgkin lymphoma (HL) and EBV-positive diffuse large B cell lymphoma, not otherwise specified (NOS), than any other LA country. Adult T cell lymphoma is endemic to the North of Brazil and Chile. While only few cases of KSHV-positive lymphomas were found, in spite of the close correlation of Kaposi sarcoma and the prevalence of pathogenic types of KSHV. Both EBV-associated HL and Burkitt lymphoma mainly affect young children, unlike in developed countries, in which adolescents and young adults are the most affected, correlating with an early EBV seroconversion for LA population despite of lack of infectious mononucleosis symptoms. High endemicity of KSHV and HTLV infection was observed among Amerindian populations, with differences between Amazonian and Andean populations.
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Affiliation(s)
- Paola Chabay
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Daniela Lens
- Flow Cytometry and Molecular Biology Laboratory, Departamento Básico de Medicina, Hospital de Clínicas/Facultad de Medicina, Universidad de la República, CP 11600 Montevideo, Uruguay;
| | - Rocio Hassan
- Oncovirology Laboratory, Bone Marrow Transplantation Center, National Cancer Institute “José Alencar Gomes da Silva” (INCA), Ministry of Health, 20230-130 Rio de Janeiro, Brazil;
| | | | - Fabiola Valvert Gamboa
- Department of Medical Oncology, Cancer Institute and National League against Cancer, 01011 Guatemala City, Guatemala;
| | - Iris Rivera
- Department of Hematology, Salvadoran Institute of Social Security, Medical Surgical and Oncological Hospital (ISSS), 1101 San Salvador, El Salvador;
| | - Fuad Huamán Garaicoa
- Department of Pathology, National Cancer Institute—Society to Fight Cancer (ION-SOLCA), Santiago de Guayaquil Catholic University, Guayaquil 090615, Ecuador;
| | - Stella Maris Ranuncolo
- Cell Biology Department, Institute of Oncology “Angel H. Roffo” School of Medicine, University of Buenos Aires, C1417DTB Buenos Aires, Argentina;
| | - Carlos Barrionuevo
- Department of Pathology, National Institute of Neoplastic Diseases, National University of San Marcos, 15038 Lima, Peru;
| | - Abigail Morales Sánchez
- Research Unit in Virology and Cancer, Children’s Hospital of Mexico Federico Gómez, 06720 Mexico City, Mexico;
| | - Vanesa Scholl
- Department of Integrated Genomic Medicine, Conciencia-Oncohematologic Institute of Patagonia, 8300 Neuquén, Argentina;
| | - Elena De Matteo
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Ma. Victoria Preciado
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Ezequiel M. Fuentes-Pananá
- Research Unit in Virology and Cancer, Children’s Hospital of Mexico Federico Gómez, 06720 Mexico City, Mexico;
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Pires CAA, Noronha MAN, Monteiro JCMS, da Costa ALC, Abreu Júnior JMDC. Kaposi's sarcoma in persons living with HIV/AIDS: a case series in a tertiary referral hospital. An Bras Dermatol 2018; 93:524-528. [PMID: 30066758 PMCID: PMC6063130 DOI: 10.1590/abd1806-4841.20186978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/08/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Kaposi's sarcoma (KS) is a rare neoplasm with indolent progression. Since 1981, the Kaposi's sarcoma epidemic has increased as co-infection with HIV. OBJECTIVES The study aimed to identify the clinical and demographic characteristics and therapeutic approaches in HIV/AIDS patients in a regional referral hospital. METHODS We analyzed the medical records of 51 patients with histopathological diagnosis of Kaposi's sarcoma hospitalized at Hospital Universitário João de Barros Barreto (HUJBB) from 2004 to 2015. RESULTS The study sample consisted of individuals 15 to 44 years of age (80.4%), male (80.4%), single (86.3%), and residing in Greater Metropolitan Belém, Pará State, Brazil. The primary skin lesions identified at diagnosis were violaceous macules (45%) and violaceous papules (25%). Visceral involvement was seen in 62.7%, mainly affecting the stomach (75%). The most frequent treatment regimen was 2 NRTI + NNRTI, and 60.8% were referred to chemotherapy. STUDY LIMITATIONS We assumed that more patients had been admitted to hospital without histopathological confirmation or with pathology reports from other services, so that the current study probably underestimated the number of KS cases. CONCLUSION Although the cutaneous manifestations in most of these patients were non-exuberant skin lesions like macules and papules, many already showed visceral involvement. Meticulous screening of these patients is thus mandatory, even if the skin lesions are subtle and localized.
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Affiliation(s)
- Carla Andréa Avelar Pires
- Department of Clinical Medicine, Universidade Federal do
Pará, Belém (PA), Brazil
- Department of Dermatology, Universidade do Estado do Pará,
Belém (PA), Brazil
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Hulaniuk ML, Torres O, Bartoli S, Fortuny L, Burgos Pratx L, Nuñez F, Salamone H, Corach D, Trinks J, Caputo M. Increased prevalence of human herpesvirus type 8 (HHV-8) genome among blood donors from North-Western Argentina. J Med Virol 2016; 89:518-527. [DOI: 10.1002/jmv.24656] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 01/24/2023]
Affiliation(s)
- María Laura Hulaniuk
- Basic Science and Experimental Medicine Institute (ICBME); University Institute of the Italian Hospital; Buenos Aires Argentina
| | - Oscar Torres
- Transfusion Medicine Unit; “Ramón Sardá” Maternity Hospital; Buenos Aires Argentina
| | - Sonia Bartoli
- Transfusion Medicine Unit; “Pablo Soria” Hospital; San Salvador de Jujuy Jujuy Argentina
| | - Lisandro Fortuny
- Transfusion Medicine Unit; Italian Hospital of Buenos Aires; Buenos Aires Argentina
| | - Leandro Burgos Pratx
- Transfusion Medicine Unit; Italian Hospital of Buenos Aires; Buenos Aires Argentina
| | - Félix Nuñez
- Transfusion Medicine Unit; Italian Hospital of Buenos Aires; Buenos Aires Argentina
| | - Horacio Salamone
- Transfusion Medicine Unit; Italian Hospital of Buenos Aires; Buenos Aires Argentina
| | - Daniel Corach
- Universidad de Buenos Aires; Facultad de Farmacia y Bioquímica; Departamento de Microbiología; Inmunología y Biotecnología; Cátedra de Genética Forense y Servicio de Huellas Digitales Genéticas; Buenos Aires Argentina
- National Scientific and Technical Research Council (CONICET); Buenos Aires Argentina
| | - Julieta Trinks
- Basic Science and Experimental Medicine Institute (ICBME); University Institute of the Italian Hospital; Buenos Aires Argentina
- National Scientific and Technical Research Council (CONICET); Buenos Aires Argentina
| | - Mariela Caputo
- Universidad de Buenos Aires; Facultad de Farmacia y Bioquímica; Departamento de Microbiología; Inmunología y Biotecnología; Cátedra de Genética Forense y Servicio de Huellas Digitales Genéticas; Buenos Aires Argentina
- National Scientific and Technical Research Council (CONICET); Buenos Aires Argentina
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Lindenau JD, Salzano FM, Guimarães LSP, Callegari-Jacques SM, Hurtado AM, Hill KR, Petzl-Erler ML, Tsuneto LT, Hutz MH. Distribution patterns of variability for 18 immune system genes in Amerindians - relationship with history and epidemiology. ACTA ACUST UNITED AC 2013; 82:177-85. [DOI: 10.1111/tan.12183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 06/25/2013] [Accepted: 07/17/2013] [Indexed: 12/22/2022]
Affiliation(s)
- J. D. Lindenau
- Departamento de Genética; Universidade Federal do Rio Grande do Sul; Porto Alegre; Brazil
| | - F. M. Salzano
- Departamento de Genética; Universidade Federal do Rio Grande do Sul; Porto Alegre; Brazil
| | - L. S. P. Guimarães
- Unidade de Epidemiologia e Estatística; Hospital de Clínicas de Porto Alegre; Porto Alegre; Brazil
| | | | - A. M. Hurtado
- School of Human Evolution & Social Change; Arizona State University; Tempe; AZ; USA
| | - K. R. Hill
- School of Human Evolution & Social Change; Arizona State University; Tempe; AZ; USA
| | - M. L. Petzl-Erler
- Departamento de Genética; Universidade Federal do Paraná; Curitiba; Brazil
| | - L. T. Tsuneto
- Departamento de Análises Clínicas; Universidade Estadual de Maringá; Maringá; Brazil
| | - M. H. Hutz
- Departamento de Genética; Universidade Federal do Rio Grande do Sul; Porto Alegre; Brazil
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Borges JD, Souza VAUF, Giambartolomei C, Dudbridge F, Freire WS, Gregório SA, Torrez PPQ, Quiroga M, Mayaud P, Pannuti CS, Nascimento MC. Transmission of human herpesvirus type 8 infection within families in american indigenous populations from the Brazilian Amazon. J Infect Dis 2012; 205:1869-76. [PMID: 22474036 DOI: 10.1093/infdis/jis278] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The intrafamilial dynamics of endemic infection with human herpesvirus type 8 (HHV-8) in Amerindian populations is unknown. METHODS Serum samples were obtained from 517 Amerindians and tested for HHV-8 anti-latent nuclear antigen (anti-LANA) and antilytic antibodies by immunofluorescence assays. Logistic regression and mixed logistic models were used to estimate the odds of being HHV-8 seropositive among intrafamilial pairs. RESULTS HHV-8 seroprevalence by either assay was 75.4% (95% confidence interval [CI]: 71.5%-79.1%), and it was age-dependent (P(trend) < .001). Familial dependence in HHV-8 seroprevalence by either assay was found between mother-offspring (odds ratio [OR], 5.44; 95% CI: 1.62-18.28) and siblings aged ≥10 years (OR 4.42, 95% CI: 1.70-11.45) or siblings in close age range (<5 years difference) (OR 3.37, 95% CI: 1.21-9.40), or in families with large (>4) number of siblings (OR, 3.20, 95% CI: 1.33-7.67). In separate analyses by serological assay, there was strong dependence in mother-offspring (OR 8.94, 95% CI: 2.94-27.23) and sibling pairs aged ≥10 years (OR, 11.91, 95% CI: 2.23-63.64) measured by LANA but not lytic antibodies. CONCLUSIONS This pattern of familial dependence suggests that, in this endemic population, HHV-8 transmission mainly occurs from mother to offspring and between close siblings during early childhood, probably via saliva. The mother to offspring dependence was derived chiefly from anti-LANA antibodies.
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Affiliation(s)
- Jaila D Borges
- Laboratório de Virologia (LIMHC), Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo
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