Classic type of Kaposi's sarcoma and human herpesvirus 8 infection in Xinjiang, China

Abstract

We report 17 cases of the classic type of Kaposi's sarcoma in Xinjiang, which is located in the north-western area of China surrounded by Mongolia in the east, Russia in the north and Kazakhstan in the west. Fifteen of the patients were of the Uygur people. All patients were male and did not have acquired immunodeficiency syndrome. Most of the lesions were found in the lower and/or upper extremities, with 16 patients showing multiple lesions. Immunohistochemical examination of the lesions revealed that human herpesvirus 8 (HHV-8)-encoded latency-associated nuclear antigen was expressed in the nuclei of spindle-shaped tumor cells. HHV-8 DNA was detected by polymerase chain reaction in all seven cases examined. Phylogenetic tree analysis revealed that DNA sequences of the HHV-8-encoded K1 gene in the seven Kaposi's sarcoma cases were classified as subtype C that was common in the Mediterranean, the Middle East and East Asian countries. In addition, using immunofluorescence we investigated the seroprevalence of HHV-8 in 73 Uygur patients with diseases other than Kaposi's sarcoma. Surprisingly, the serological study revealed that 34 of the patients (46.6%) were positive for antibodies against HHV-8, suggesting that HHV-8 infection is widespread in Xinjiang area. The occurrence of the classic type of Kaposi's sarcoma with a high seropositivity rate implies that Xinjiang is the most endemic area for HHV-8 infection in the world known to date. Considering that Xinjiang is located at the middle point of the Silk Road that used to extend from Rome to China, these data imply that the virus may have been in circulation in this area due to the migration of the people via the Silk Road.

AIDS and associated malignancies

“…Very little is known about KSHV infection in China even though EBV infection was found to be ubiquitous. There were only two reported studies in China; the study by Dilnur et al [45] found that KSHV was associated with KS in China. The study by Du et al [46] in the outskirt of China in the Xinjiang autonomy region, where there is a high incidence of HIV-1 infection, showed that there was a high HHV-8 infection rate.…”

Seroprevalence of human herpesvirus‐8 in blood donors from different geographical regions of Argentina, Brazil, and Chile

“…However, regional differences have been reported. In Asia, geographic pockets with lower or higher (1.4-46.6%) prevalences were found Dilnur et al, 2001;Satoh et al, 2001]. In Europe, frequencies from 3.0 to 35% have been reported [Gambus et al, 2001;Preiser et al, 2001;Santarelli et al, 2001].…”

Classical Kaposi’s Sarcoma in a Nigerian Farmer: A Case Report

“…The fact that our patient is of sub-Saharan African origin is rather unusual for classical KS. Nevertheless, occurrence of classical KS in non-Mediterranean countries such as Peru and China has been documented [7,8]. The striking geographical variation in the incidence of classical KS and African-endemic KS points to a role for environmental factors.…”