Kaposi's Sarcoma (kaposi's + sarcoma)

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Distribution within Medical Sciences

Selected Abstracts


Mehmet Bektas
A case of Kaposi's sarcoma (KS) in a 70-year-old man who was using corticosteroid for the treatment of asthma is presented. KS lesions occurred in the skin, colon, and rectum. Macroscopic appearances of the lesions varied from polypoid, hemorrhagic mucosal nodules and ulcers to red macules in the mucosal plane to plaque-like indurations of the wall. As the case was HIV negative, it is believed that KS developed due to corticosteroid-induced immunosuppression. [source]

ID2-VEGF-related Pathways in the Pathogenesis of Kaposi's Sarcoma: A Link Disrupted by Rapamycin

G. Stallone
The Id-proteins are a family of four related proteins implicated in the control of differentiation and cell-cycle progression. Down-regulation of Id-gene expression is essential for the differentiation of several cell types. In addition, deregulated Id2 activity inhibits the Rb tumor suppressor pathway and promotes the expression of vascular endothelial growth factor (VEGF). Several members of VEGF family could be involved in Kaposi's sarcoma (KS) development and progression. Lymphatic vascular endothelial hyaluronan receptor-1 (LYVE-1) is the first marker of lymphatic endothelial competence during development in the mature vasculature, and is also expressed on KS spindle cells. Rapamycin (RAPA), an immunosuppressive drug, has been shown to reverse KS growth and to reduce tumor angiogenesis. We evaluate, in transplantation-associated KS and in cultured KS-cells the RAPA effect on Id2 and on de novo lymphangiogenesis. Markers of lymphatic-endothelial-cells (VEGFR-3, LYVE-1) and Id2, expressed at low levels within the normal skin, were up-regulated in KS and returned to normal levels after RAPA introduction. The association between Id2 and lymphangiogenesis is suggested by co-localization of Id2, VEGFR-3 and LYVE-1. RAPA inhibition on Id2 expression was confirmed in vitro in KS-cells, both in basal conditions and upon stimulation with VEGF. In conclusion, our data would suggest a novel molecular mechanism for the antineoplastic effects of RAPA in posttransplant KS. [source]

Symptomatic Pulmonary Allograft Kaposi's Sarcoma in Two Lung Transplant Recipients

S. J. Sathy
Kaposi's sarcoma (KS) is associated with solid-organ transplantation, but is extremely rare after lung transplantation. In this report, we describe two unique cases of lung transplant recipients who developed KS in the lung allograft and were treated with sirolimus and liposomal doxorubicin. One patient survived 12 months after the diagnosis of KS; the other survived 3 months after diagnosis and was found to have concomitant EBV-negative, HHV-8-positive B-cell lymphoma. We demonstrate a partial response of pulmonary KS to reduced immunosuppression and the initiation of sirolimus in one patient, as well as an association between increasing HHV-8 viremia and progression of pulmonary KS. Our report highlights the importance of secondary malignancies in patients with transplant-related KS and supports the association between HHV-8 infection and EBV-negative PTLD. [source]


Mehmet Bektas
A case of Kaposi's sarcoma (KS) in a 70-year-old man who was using corticosteroid for the treatment of asthma is presented. KS lesions occurred in the skin, colon, and rectum. Macroscopic appearances of the lesions varied from polypoid, hemorrhagic mucosal nodules and ulcers to red macules in the mucosal plane to plaque-like indurations of the wall. As the case was HIV negative, it is believed that KS developed due to corticosteroid-induced immunosuppression. [source]

Concomitant and fatal HHV-8+ multicentric Castleman's disease and Kaposi's sarcoma in the same lymph node of an HIV, liver transplant patient

S Gaitonde
First page of article [source]

Causes of the first AIDS-defining illness and subsequent survival before and after the advent of combined antiretroviral therapy,

HIV MEDICINE, Issue 4 2008
S Grabar
Objectives To analyse the impact of combined antiretroviral treatment (cART) on survival with AIDS, according to the nature of the first AIDS-defining clinical illness (ADI); to examine trends in AIDS-defining causes (ADC) and non-AIDS-defining causes (non-ADC) of death. Methods From the French Hospital Database on HIV, we studied trends in the nature of the first ADI and subsequent survival in France during three calendar periods: the pre-cART period (1993,1995; 8027 patients), the early cART period (1998,2000; 3504 patients) and the late cART period (2001,2003; 2936 patients). Results The three most frequent initial ADIs were Pneumocystis carinii (jirovecii) pneumonia (PCP) (15.6%), oesophageal candidiasis (14.3%) and Kaposi's sarcoma (13.9%) in the pre-cART period. In the late cART period, the most frequent ADIs were tuberculosis (22.7%), PCP (19.1%) and oesophageal candidiasis (16.2%). The risk of death after a first ADI fell significantly after the arrival of cART. Lower declines were observed for progressive multifocal leukoencephalopathy, lymphoma and Mycobacterium avium complex infection. After an ADI, the 3-year risk of death from an ADC fell fivefold between the pre-cART and late cART periods (39%vs. 8%), and fell twofold for non-ADCs (17%vs. 9%). Conclusions The relative frequencies of initial ADI have changed since the advent of cART. Tuberculosis is now the most frequent initial ADI in France; this is probably the result of the increasing proportion of migrants from sub-Saharan Africa. After a first ADI, cART has a major impact on ADCs and a smaller impact on deaths from other causes. The risk of death from AIDS and from other causes is now similar. [source]

Malignancies in HIV-infected Thai patients,

HIV MEDICINE, Issue 5 2007
S Kiertiburanakul
Of 1416 HIV-infected patients seen at Ramathibodi Hospital over a 5-year period (1999,2003), 42 were diagnosed with malignancies, giving a prevalence of 3%. Twenty-one of these patients (50%) were men and their mean age was 40.8 years. The median CD4 cell count was 235 cells/,L. AIDS-related malignancies were found in 26 patients (62%). The most common AIDS-related malignancies were non-Hodgkin's lymphoma (NHL) (33%), cervical cancer (21%) and Kaposi's sarcoma (KS) (5%). Breast cancer was the most common non-AIDS-related malignancy (10%). Eleven patients (26%) died. The 75% survival time of patients who received treatment for their malignancy was longer than that of patients who received no treatment (18.3 vs 1.2 months; P<0.01). [source]

Pulmonary pathology in patients with AIDS: an autopsy study from Mumbai

HIV MEDICINE, Issue 4 2001
DN Lanjewar
Objective Although India has a high prevalence of HIV/AIDS, the associated pathologies responsible for morbidity have not been evaluated previously in a representative study. Hence, an autopsy study was carried out to analyse the spectrum of pulmonary lesions in patients with HIV/AIDS. Methods A retrospective and prospective autopsy study was carried out during 1988,2000 at Mumbai, India. Lungs from 143 adults, with at least 10 sections from each case, were examined using routine and special stains. Results The risk factors for 97 men (68%) and 38 women (27%) included: heterosexual sex with multiple partners (135 cases, 95%); blood transfusions (three cases; 2%); sex between men (two cases; 1%); and unknown risk factors (three cases, 2%). Pulmonary pathology was observed in 126 (88%) cases. The lesions identified were tuberculosis (85 cases, 59%), bacterial pneumonia (26 cases, 18%), cytomegalovirus (CMV) infection (10 cases, 7%), cryptococcosis (eight cases, 6%), Pneumocystis carinii pneumonia (seven cases, 5%), aspergillosis (four cases, 3%), toxoplasmosis (two cases, 1%), Kaposi's sarcoma (one case, 1%), squamous cell carcinoma (one case, 1%). Two or more infections were observed in 18 (13%) cases. Conclusions Pulmonary diseases and risk factors among patients with AIDS in India differ from those reported in industrialized countries. Tuberculosis was the most frequently observed pulmonary infection, followed by bacterial pneumonia and CMV pneumonitis. In contrast with industrialized countries, PCP remains less common in our patients. The information on opportunistic infections obtained in this study will be useful for managing HIV/AIDS cases at district level hospitals where diagnosing specific HIV-associated diseases is not always possible. [source]

Substantial regional differences in human herpesvirus 8 seroprevalence in sub-Saharan Africa: Insights on the origin of the "Kaposi's sarcoma belt",,

Sheila C. Dollard
Abstract Equatorial Africa has among the highest incidences of Kaposi's sarcoma (KS) in the world, thus earning the name "KS Belt." This was the case even before the HIV epidemic. To date, there is no clear evidence that HHV-8 seroprevalence is higher in this region but interpretation of the available literature is tempered by differences in serologic assays used across studies. We examined representatively sampled ambulatory adults in Uganda, which is in the "KS Belt," and in Zimbabwe and South Africa which are outside the Belt, for HHV-8 antibodies. All serologic assays were uniformly performed in the same reference laboratory by the same personnel. In the base-case serologic algorithm, seropositivity was defined by reactivity in an immunofluorescence assay or in 2 enzyme immunoassays. A total of 2,375 participants were examined. In Uganda, HHV-8 seroprevalence was high early in adulthood (35.5% by age 21) without significant change thereafter. In contrast, HHV-8 seroprevalence early in adulthood was lower in Zimbabwe and South Africa (13.7 and 10.8%, respectively) but increased with age. After age adjustment, Ugandans had 3.24-fold greater odds of being HHV-8 infected than South Africans (p < 0.001) and 2.22-fold greater odds than Zimbabweans (p < 0.001). Inferences were unchanged using all other serologic algorithms evaluated. In conclusion, HHV-8 infection is substantially more common in Uganda than in Zimbabwe and South Africa. These findings help to explain the high KS incidence in the "KS Belt" and underscore the importance of a uniform approach to HHV-8 antibody testing. [source]

Regression of post-transplant Kaposi's sarcoma using sirolimus

Summary Kaposi's sarcoma (KS) is a recognised complication following kidney transplantation, but the incidence varies according to the geographical area. Although it is a rare tumour, its incidence increases dramatically after solid-organ transplantation. The immunosuppressive medications reactivate human herpes virus 8, which has been proposed as the offending agent. The usual treatment of KS is to reduce immunosuppression, chemotherapy and radiotherapy. Nevertheless, the mortality still remains considerably high and has been reported between 8 and 14%. Sirolimus (SRL) has properties which may be useful in the management of some post-transplant tumours such as KS. We report a renal transplant patient with KS, who had multiple relapses after radiotherapy but responded well to the change of immunosuppression from cyclosporine to SRL. [source]

Evaluation of coexistence of the Human Herpesvirus type 8 (HHV-8) infection and pemphigus

Naser Tayyebi Meibodi Associate Professor
Background, Human Herpesvirus type 8 (HHV-8) is a new member of the herpes virus family, first found in the tissue of acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma. Environmental factors including viral infection may play a role in the onset and/or development of pemphigus. Some studies based on polymerase chain reaction findings suggest an association between HHV-8 and pemphigus. The aim of this study is investigation of the association of pemphigus with HHV-8 and the relationship between inflammatory and acantholytic cells with HHV-8 infection. Methods, Tissue-extracted DNA from 41 paraffin-embedded skin tissues from patients first presenting with pemphigus was tested using nested PCR for the presence of HHV-8. A total of 37 cases had pemphigus vulgaris (PV) and 4 patients had pemphigus foliaceus (PF). For our control group, normal skin of 21 cosmetic surgery patients were included. Furthermore, microscopic slides with H&E staining were evaluated for the number of inflammatory and acantholytic cells per microscopic field. Results, Skin lesions from 13 of 37 patients (35.1%) with PV and 2 of 4 cases (50%) with PF were positive for HHV-8 DNA. All specimens in our control group were negative for this virus. Conclusion, HHV-8 infection might be a contributing factor in the initiation or development of pemphigus. [source]

Patterns of skin manifestations and their relationships with CD4 counts among HIV/AIDS patients in Cameroon

Mbuagbaw Josephine
Background, Skin manifestations are common clinical features among HIV/AIDS-positive patients. Their frequencies, patterns and associated factors have been shown to vary from region to region. The present study is aimed at documenting skin manifestations and their relationships with CD4 cell counts among HIV/AIDS patients in Cameroon. Methods, This study lasted for 16 months (from September 2001 to December 2002). After informed consent, data on skin disorders, HIV status, CD4 and viral load were obtained by physical examination and laboratory methods. Results, Of the 384 subjects studied, 236 (61.5%) were females and 148 (38.5%) were males. Up to 264 (68.8%) patients presented with at least one type of skin problem. Generalized prurigo, oral candidiasis, herpes zoster, and vaginal candidiasis were the most common skin problems. Mean CD4 cell count (128 ± 85 cells/mm3) and mean viral load (79,433 copies/mL) in patients with herpes zoster were higher (P < 0.001). Patients with oral candidiasis and vaginal candidiasis had significantly lower (109 ± 127 cells/mm3, P < 0.02) and higher (131 ± 85 cells/mm3, P < 0.05) mean CD4 cell counts, respectively. Prurigo was associated with higher mean viral load (31,623 ± 20 copies/mL, P < 0.04). Viral lesions were associated with high mean CD4 cell count (123 ± 83 cells/mm3, P < 0.001). Kaposi's sarcoma and parasitic lesions (crusted scabies) were both, respectively, associated with lower mean CD4 cell counts [(78 ± 66 cells/mm3, P < 0.001) (6 ± 0 cells/mm3, P < 0.04)]. Conclusion, We conclude, first that skin problems are common in HIV-infected individuals in Cameroon and that patients with advanced stages of these problems have relatively very low mean CD4 cell counts. Second, that mucocutaneous disorders like vaginal candidiasis and herpes zoster occur early in HIV infection while Kaposi's sarcoma is common in advanced HIV infection. [source]

Kaposi's sarcoma after allogeneic peripheral blood stem cell transplantation

Sara Isabel Palencia
No abstract is available for this article. [source]

Regulation of growth signalling and cell cycle by Kaposi's sarcoma-associated herpesvirus genes

Shamindra Direkze
Summary Kaposi's sarcoma-associated herpesvirus (KSHV) is the primary aetiological agent of at least three malignancies associated with HIV infection and immunosuppression: Kaposi's sarcoma, primary effusion lymphoma and multicentric Castleman's disease. KSHV encodes proteins that deregulate key checkpoints in the signalling pathways governing cell proliferation, which may ultimately contribute to the virus' oncogenic potential. To alter cellular signalling associated with proliferation, these viral proteins function like growth factor ligands/receptors, signal transduction proteins, transcription factors and cell cycle regulators. This review focuses on the mechanisms by which some KSHV-encoded proteins activate signalling pathways and cell proliferation and their role in the pathogenesis of KSHV-driven mechanisms. [source]

Emerging targets and novel strategies in the treatment of AIDS-related Kaposi's sarcoma: Bidirectional translational science

Bruce J. Dezube
Through the mentorship process, Dr. Arthur Pardee emphasized the critical importance of bidirectional translational research,not only advancing drug development from bench to bedside, but also bringing back precious clinical material to the laboratory to assess the biologic effects of therapeutic agents on their targets. This mini-review focuses on the signal transduction pathways of Kaposi's sarcoma (KS) and on how the knowledge of such pathways has led to the rational development of molecularly targeted pathogenesis-driven therapies. Acquired immune deficiency syndrome (AIDS) related-KS results from co-infection with human immunodeficiency virus and KS herpesvirus/human herpesvirus-8 (KSHV/HHV8), which leads to the development of an angiogenic-inflammatory state that is critical in the pathogenesis of KS. KS is driven by KSHV/HHV8-specific pathways, which include viral G protein-coupled receptor (vGPCR), viral interleukin-6 (vIL-6), and viral chemokine homologues. In addition, cellular growth/angiogenic pathways, such as vascular endothelial growth factor (VEGF), insulin-like growth factor, platelet-derived growth factor (PDGF), angiopoietin and matrix metalloproteinases (MMPs) are "pirated" by KSHV/HHV8. As a very tangible example of how translational research has led to a marked improvement in patient outcome, the signal transduction inhibitor imatinib (a tyrosine kinase inhibitor of c-kit and PDGF) was administered to patients with KS whose tumors were serially biopsied. Not only did the patients' tumors regress, but also the regression was correlated with the inhibition of PDGF receptor (PDGFR) in the biopsy samples. Recent and future clinical trials of molecularly targeted therapy for the treatment of KS are a prelude to a shift in the paradigm of how KS is managed. J. Cell. Physiol. 209: 659,662, 2006. © 2006 Wiley-Liss, Inc. [source]

KSHV/HHV8-associated primary cutaneous plasmablastic lymphoma in a patient with Castleman's disease and Kaposi's sarcoma

Wenhua Liu
Three months following the diagnosis of KS affecting a left cervical lymph node and Castleman's disease with bone marrow involvement, he presented with a subcutaneous, tender lesion on his left arm. A skin biopsy demonstrated a superficial and deep, interstitial-nodular infiltrate of severely atypical lymphoid cells showing plasmacytoid features, numerous mitotic figures, and frequent individual apoptotic tumor cells. The morphologic features were those of plasmablastic lymphoma (PBL). Immunohistochemical study showed that the lymphoma cells strongly expressed CD45, CD30, and KSHV/HHV8 latency-associated nuclear antigen. KSHV/HHV8 was also detected in the biopsy sections of the patient's KS and Castleman's disease. Epstein,Barr virus in situ hybridization was diffusely positive. In situ hybridization demonstrated ,-light chain restriction. Although KSHV/HHV8 has been individually associated with KS, Castleman's disease, and PBL, this appears to be the first reported case in which all three entities were present simultaneously in one person, suggesting a critical role of KSHV/HHV8 as a common denominator in the pathogenesis of these diseases. [source]

Lymphedematous HIV-associated Kaposi's sarcoma

Pratistadevi K. Ramdial
Background:, Advanced Kaposi's sarcoma is frequently associated with chronic lymphedema (cLO). The histopathological features of lymphedematous HIV-associated KS (KS) are poorly documented and the co-existence of fibroma-like nodules in lymphedematous KS is under-recognized. The aims of this study were to assess the clinicopathological spectrum and diagnostic difficulties associated with lymphedematous KS and to highlight the clinicopathological profile of fibroma-like nodules. In addition, the pathogenesis of fibroma-like nodules and cLO is revisited. Materials and methods:, Prospective 17-month clinicopathological study of all biopsies from patients with lymphedematous KS. Results:, Seventy-four biopsies, the majority from the lower limbs, from 41 patients were evaluated. Nineteen, 14, five and three patients had one, two, three or four biopsies each, respectively. In 14 biopsies, there was poor clinicopathological correlation of KS stage. Exclusive lesional KS (patch, plaque, nodule or lymphangioma-like) was identified in 29 biopsies; 23 and eight biopsies demonstrated KS or fibroma-like morphology and the adjacent dermis demonstrated cLO. There was variable intratumoral and peritumoral venous compression and lymphatic dilatation. Fourteen biopsies demonstrated cLO exclusively. Smaller fibroma-like nodules lacked KS spindle cells, whereas >5 mm nodules demonstrated focal KS spindle cell proliferation and aggregation on extensive sectioning. The subcutis of 42 biopsies demonstrated variable fibrosis, hemosiderin deposits, lymphocytes, plasma cells, KS, interstitial granular material and pools of lymph fluid. Subcutaneous abscesses were identified in six biopsies. All biopsies had variable epidermal features of cLO. Conclusions:, cLO influences clinicopathological correlation of KS stage and may also mask the presence of KS and the co-existence of subcutaneous abscesses. Smaller fibroma-like nodules are hypothesized to be a manifestation of cLO that have the potential to acquire the characteristics of KS. Lymphatic and venous obstruction, protein-rich interstitial fluid, tissue hemosiderin and subcutaneous infection are hypothesized to play a combined role in the evolution and perpetuation of cLO. [source]

Human Herpesvirus-8: A Useful Marker for Distinguishing Kaposi Sarcoma and Kaposi Sarcoma-like Pyogenic Granuloma

A. Uzieblo
Kaposi's sarcoma (KS) is a vascular neoplasm associated with human herpesvirus-8 (HHV-8) infection. On occasion, KS may histologically mimic pyogenic granulomas (PG), a common benign vascular tumor of the skin. Using immunoperoxidase stains, we examined 28 PG and 4 PG-like KS for HHV-8 to determine the specificity of positive staining in this setting. All PG-like KS demonstrated nuclear staining for HHV-8. No staining was identified in any of the PG. Furthermore, histologic criteria often used to differentiate between these two entities were not helpful in difficult cases. The only distinguishing features were the presence/absence of HHV-8 staining and, in some cases, clinical history. The presence of HHV-8 nuclear staining appears to be a specific marker for KS when comparing PG and PG-like KS. Given the lack of distinguishing morphologic criteria, we suggest performing immunoperoxidase stains for HHV-8 on any PG occurring in a clinically atypical setting. [source]

Expression of the caveolins in dermal vascular tumors

Michael B. Morgan
Introduction: Histopathologic criteria are usually sufficient for the accurate distinction of benign from malignant dermal vascular tumors. A minority of cases, however, pose a vexing diagnostic dilemma. Recent studies suggest that caveolin, a scaffolding cell membrane protein, may prove helpful in predicting the biologic behavior of endothelial-derived neoplasms. Methods: We analyzed a series of 30 dermal vascular tumors including 12 lobular capillary hemangiomas (LCH), 4 cases of targetoid hemosiderotic hemangiomas (TH), 4 cases of tufted angioma (TA), 12 cases of Kaposi's sarcoma (KS), 4 epithelioid (EH) and 1 spindle cell hemangioendothelioma (SH), and 4 cases of angiosarcoma (AS). The distribution of immunoreactivity was analyzed by quantifying cell membrane staining in each case. Results: There was a statistically significant difference in the expression of caveolin between LCH (mean labeling index=91.6), TH (mean labeling index=89.7), and TA (mean labeling index=87.2) and the cases of KS (mean labeling index=21.6, EH mean labeling index=23.1), and the AS ( mean labeling index=6.3). Conclusions: These results indicate that antibodies to caveolin may be useful in separating benign and malignant dermal vascular tumors and possibly implicates this peptide in their pathogenesis. [source]

Patterns of antibodies against latent and lytic antigens of human herpesvirus 8 in an endemic population and patients with Kaposi's sarcoma in Mozambique

Adele Caterino-de-Araujo
Abstract The patterns of antibodies against latent and lytic antigens of human herpesvirus 8 (HHV-8) were assessed using immunofluorescence assays of samples from 155 persons seropositive for HHV-8 seen at public health centers and 24 patients with Kaposi's sarcoma (KS) from Mozambique. Of the 155 persons without KS, 48 (31%) had antibodies against latent antigens only, 29 (18.7%) had antibodies against lytic antigens only, and 78 (50.3%) had antibodies against both types of antigen. The HHV-8 antibody titer tended to increase with age until age 40, after which it began to decrease. High titers of antibodies against latent and lytic antigens of HHV-8 were detected mostly in persons co-infected with HIV, and these increased titers could have a predictive value. All patients with KS except four patients who were seronegative for HHV-8 had elevated titers of HHV-8 antibodies, predominantly against latent antigens. The data suggest the potential for an increase in the development of KS in this endemic area for HHV-8. J. Med. Virol. 82:1576,1581, 2010. © 2010 Wiley-Liss, Inc. [source]

Detection of Merkel cell polyomavirus in Merkel cell carcinoma and Kaposi's sarcoma

Harutaka Katano
Abstract Merkel cell carcinoma is a rare malignancy that sometimes occurs in the skin of elderly people. Recently, a new human polyomavirus, Merkel cell polyomavirus (MCPyV) was identified in Merkel cell carcinoma. In the present study, MCPyV-DNA was detected in 6 of 11 (55%) cases of Merkel cell carcinoma by nested PCR and real-time PCR. Histologically, MCPyV-positive cases showed round and vesicular nuclei with a fine granular chromatin and small nucleoli, whereas MCPyV-negative cases showed polygonal nuclei with diffusely distributed chromatin. Real-time PCR analysis to detect the MCPyV gene revealed that viral copy numbers ranged 0.04,0.43 per cell in cases of Merkel cell carcinoma. MCPyV was also detected in 3 of 49 (6.1%) cases of Kaposi's sarcoma (KS), but not in 192 DNA samples of other diseases including 142 autopsy samples from 20 immunodeficient patients. The MCPyV copy number in KS was lower than that in Merkel cell carcinoma. PCR successfully amplified a full-length MCPyV genome from a case of KS. Sequence analysis revealed that the MCPyV isolated from KS had 98% homology to the previously reported MCPyV genomes. These data suggest that the prevalence of MCPyV is low in Japan, and is at least partly associated with the pathogenesis of Merkel cell carcinoma. J. Med. Virol. 81:1951,1958, 2009. © 2009 Wiley-Liss, Inc. [source]

Seroprevalence of Kaposi's sarcoma-associated herpesvirus and risk factors in Xinjiang, China,

Bishi Fu
Abstract Xinjiang, China is an endemic area for Kaposi's sarcoma (KS) but the seroprevalence of Kaposi's sarcoma-associated herpesvirus (KSHV) and risk factors remain undefined. In this study, antibodies to one KSHV latent protein (ORF73) and two KSHV lytic proteins (ORF65 and ORF-K8.1) were examined in 2,228 subjects from the general population and 37 subjects infected with HIV-1 in Xinjiang, and 560 subjects from the general population in Hubei, a low KS incidence region. The serostatus of a serum sample was defined based on positive results in any one of the three serologic assays. The seroprevalence of KSHV in the general population was higher in Xinjiang than in Hubei (19.2% vs. 9.5%; odds ratios [OR], 2.28; 95% confidence interval [CI], 1.68,3.08; P,<,0.001). Among the ethnic groups in Xinjiang, 68 (15.8%) Han, 182 (20.7%) Uygur, 140 (19.9%) Hazakh, 9 (33.3%) Xibo, and 29 (16.8%) Hui were KSHV-seropositive, respectively. Compared to the Han, the latter groups had an increase in the risk of KSHV of 62.2%, 63.8%, 180.1%, and 30.2% (P,=,0.003, 0.004, 0.018, and 0.286, respectively). Subjects aged <20, 20,50, and >50 had a seroprevalence of KSHV of 11.8%, 17.9%, and 24.6%, respectively. Compared to subjects aged <20, the latter groups had an increase in the risk of KSHV of 63.3% and 144.5% (P,=,0.009 and <0.001, respectively). Subjects infected with HIV-1 in Xinjiang had a seroprevalence of KSHV of 43.2%, and a 220% increase in the risk of KSHV compared to the general population (P,<,0.001). Similar results were obtained when the seroprevalence of KSHV was analyzed with any single or two of the three serologic assays alone. Genotyping identified three unique sequences clustered in the A clade. This study indicates that Xinjiang has a high seroprevalence of KSHV. Geographic location, ethnicity, age and HIV-1 infection are risk factors. Serologic and genotyping results suggest the introduction of KSHV into Xinjiang by specific ethnic groups. J. Med. Virol. 81:1422,1431, 2009. © 2009 Wiley-Liss, Inc. [source]

HHV8 a subtype is associated with rapidly evolving classic Kaposi's sarcoma

Roberta Mancuso
Abstract The link between human herpesvirus 8 (KSHV) and Kaposi's sarcoma (KS) has been proven, but many important aspects including risk factors, genetic predisposition to tumor development, transmission of KSHV, and the pathogenic potential of different genotypes remain to be elucidated. Possible associations between clinical parameters and antibody levels, viral load fluctuations, and viral genotype were analyzed by quantitative real-time PCR, an in-house developed IFA assay, and sequence analysis of ORF K1-VR1 in blood, serum and saliva of 38 subjects with classic KS (cKS). KSHV lytic antibodies were significantly increased in stage IV compared to stage I and II patients (p,=,0.006 and p,=,0.041, respectively). KSHV blood, serum, and saliva viral load was comparable in all stages. The highest viral loads were detected in saliva, and they decreased in stages III,IV compared to stages I,II patients. Higher concentrations of lytic antibodies and higher viral loads were observed in fast progressing cKS patients, in whom KSHV detection from blood was also more frequent. Type A KSHV strain was almost exclusively present in rapid progressors (12/17 cases), while C type was mainly present in slow progressing patients (6/7 cases). Finally, detection of type A KSHV strain associated with higher blood viral loads. KSHV lytic antibody levels and viral load can be used to monitor clinical evolution of cKS. Infection supported by KSHV A subtype is associated with more rapid progressive disease. Careful monitoring and aggressive therapeutic protocols should be considered in patients with KSHV A-supported infection. J. Med. Virol. 80:2153,2160, 2008. © 2008 Wiley-Liss, Inc. [source]

Correlations between synthetic peptide-based enzyme immunoassays and immunofluorescence assay for detection of human herpesvirus 8 antibodies in different Argentine populations

Celeste Pérez
Abstract Human herpesvirus 8 (HHV-8) antibody tests vary in sensitivity and specificity, depending on the population tested and on the type of assay. In this study, we evaluated the sensitivity and specificity of two peptide enzyme immunoassays using a multiple antigenic peptide (PK8.1-MAP) or a chimeric peptide (PK8.1-orf65) as the antigens and determined the HHV-8 seroprevalence in different Argentine polulations using an immunofluorescence assay (IFA) as reference. For analysis, when either or both of the peptide EIAs were positive, the specimen was considered positive (PEIA). We estimated the sensitivity and specificity of PEIA to be 97% using Kaposi's sarcoma (KS) patients and healthy individuals as positive and negative controls respectively. Then, we expanded the control groups to include IFA positive men who have sex with men (MSM) and IFA negative blood donors. The sensitivity decreased to 83% but specificity remained high at 98%. Concordance between PEIA and IFA was 77% for 1/40 IFA titers and increased to 90% for titers ,1/160. Seroprevalences for HHV-8 performed in the HIV positive MSM were (IFA 73.1%; PEIA55.2%); heterosexuals (52.5%, 22.2%), which includes injecting drug users (IDU) (54.0%, 32.4%) and non-IDU (51.6%, 16.1%). The inclusion of non-KS HHV-8 IFA positive individuals to the positive controls may be a substantial improvement towards the realistic assessment of assay sensitivity. These peptide EIAs can be used for trends in populations with high probablity of being HHV-8 infected and negative results should be confirmed by IFA. IFA test is still the most suitable test for populations with low probabilities of being infected. J. Med. Virol. 78:806,813, 2006. © 2006 Wiley-Liss, Inc. [source]

Effect of multiple herpesvirus infections on the progression of HIV disease in a cohort of HIV seroconverters,

Barbara Suligoi
Abstract The effects of herpesviruses infection on the progression of HIV disease remain controversial, with some studies showing accelerated progression and others showing no effect. Furthermore, the effect of concurrent infection with more than one herpesvirus on the progression of HIV disease has never been investigated. To this end, the rates of progression of HIV disease were determined after stratifying for the presence of up to five different herpesvirus infections. The study population consisted of 359 HIV-infected persons for whom the date of seroconversion was estimated (part of the Italian Seroconversion Study). One serum sample from each participant was tested for antibodies to five herpesviruses: HSV-2, CMV, HHV-6, HHV-7, and HHV-8. Univariate analysis showed that HSV-2 and HHV-8 were significantly associated with progression to AIDS, yet when adjusting for age at HIV seroconversion and for the presence of the other herpesvirus infections, only HHV-8 infection showed a significant association. The age-adjusted risk of progression to AIDS with Kaposi's sarcoma increased with the number of herpesvirus infections and was significant in individuals with four infections. The risk of progression to AIDS without Kaposi's sarcoma also increased with the number of infections, although not significantly. Similar results were found when considering CD4+ cell count <200,×,106 cells/L as the endpoint. Concurrent infection with more than one herpesvirus does not appear to have a significant effect on the course of HIV disease, except for the known association between HHV-8 and Kaposi's sarcoma. However, even after excluding Kaposi's sarcoma from the AIDS-defining endpoints, a slightly increased risk for participants with four herpesvirus infections remained. J. Med. Virol. 69:182,187, 2003. © 2003 Wiley-Liss, Inc. [source]

Clinical, histological and immunohistochemical findings in oral Kaposi's sarcoma in a series of Mexican AIDS patients.

Comparative study
Background:, The origin of spindle cells (SC) in oral Kaposi's sarcoma (OKS) is still an intriguing aspect. Thus the aim of the present study was to compare the clinical, histological and immunohistochemical characteristics of OKS and oral pyogenic granuloma (OPG), in order to contribute to the knowledge of the cells involved in Kaposi,s sarcoma pathogenesis. Methods:, In this retrospective, observational and comparative study, 39 OKS and 30 OPG cases were included. Immunohistochemical studies were performed for vimentin, ,SMA, desmin, C-kit, CD34, D2-40 and LANA-1 [human herpesvirus-8(HHV-8)]. Statistical comparisons were done using the chi-square and Wilcoxon,Mann,Whitney rank sum tests. Results:, Fourteen (35.9%) OKS cases also affected the skin, and 83.8% involved the palate. All OKS and OPG were positive for vimentin and CD34. OKS samples were positive for ,SMA, and 25.6% expressed C-kit. All OKS cases were positive for HHV-8, and the number of positive cells increased significantly from early,/,intermediate to late histological stage. D2-40 was expressed in the cellular component and vascular walls of all OKS cases, but it was negative in OPG. HHV-8 expression was increased in late histological stages of OKS lesions. Conclusions:, The expression of D2-40 marker in the vascular walls and SC supports the view of a lymphatic differentiation in neoplastic cells of OKS. Desmin, ,SMA, D2-40, C-kit and HHV-8 were the main markers differently expressed in OKS and OPG. [source]

What is the role of surgery in the treatment of Kaposi's sarcoma?

T Simonart

Lymphangioma-like Kaposi's sarcoma with gastric involvement in a patient with lung cancer

G Kalambokis

Kaposi's sarcoma , still an enigma

P Babál
ABSTRACT Kaposi's sarcoma (KS) is an unusual neoplasm that has proved to be an enigma in many ways since its original description in 1872. KS, a vascular tumour that is otherwise rare, is at present the most common neoplasm in patients with AIDS. The lesions contain spindle cells that share features with endothelial cells and smooth muscle cells and are in all likelihood primitive mesenchymal cells that can form vascular channels. These cells are monoclonal in origin indicating therefore that KS is a neoplasm. The presence of a novel type of human herpes virus, KS herpesvirus (KSHV) also called human herpesvirus type 8 (HHV8) in KS lesions support a viral ethiology. KS may be mistaken in the skin for an inflammatory or other lesion, thus skin biopsy is important for correct diagnosis, with the use of immunohistochemistry or molecular biology if needed. Radiation or interferon alpha dominate in the therapeutic approaches. [source]

Kaposi's sarcoma in a liver graft recipient

Fabrizio Panaro