Kaposi’s Sarcoma in Transplant and HIV-infected Patients: An Epidemiologic Study in Italy and France

Serraino, Diego; Angeletti, Claudio; Carrieri, Patrizia; Longo, Benedetta; Piche, Marjorie; Piselli, Pierluca; Arbustini, Eloisa; Burra, Patrizia; Citterio, Franco; Colombo, Valeria; Fuzibet, Jean Gabriel; Bello, Barbara Dal; Targhetta, S.; Grasso, Maurizia; Pozzetto, U; Bellelli, Stefania; Dorrucci, Maria; Maso, Luigino Dal; Busnach, G; Pradier, Christian; Rezza, Giovanni

doi:10.1097/01.tp.0000187864.65522.10

Cited by 50 publications

(29 citation statements)

References 14 publications

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“…Western and African countries also reported high frequencies of KS among HIV-infected individuals [20,21]. However, the incidence of KS is very low in our region.…”

Section: Tablementioning

confidence: 44%

Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India

Sachithanandham

Kannangai

Abraham³

et al. 2013

Intervirology

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Human herpes virus-8 (HHV-8) is etiologically associated with Kaposi's sarcoma. There is insufficient information on the epidemiology of HHV-8 infection from India. Blood samples from 87 human immunodeficiency virus (HIV)-infected individuals and 84 normal healthy blood donors were tested for the HHV-8 IgG antibodies. Further, a total of 309 whole blood samples from treatment-naïve HIV-1-infected individuals and from 70 normal healthy individuals were also collected and tested for HHV-8 DNA. The seroprevalence of HHV-8 was 4.7% in the South Indian population. There was no significant difference in the seroprevalence of HHV-8 in the HIV-infected and uninfected patients. None of the 379 samples tested were positive for HHV-8 DNA. Our study revealed a very low exposure of the South Indian patient population to HHV-8 and multicentric epidemiological studies are needed to understand the prevalence of HHV-8 in different regions of India and to confirm any gender-specific differences in seroprevalence.

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“…Western and African countries also reported high frequencies of KS among HIV-infected individuals [20,21]. However, the incidence of KS is very low in our region.…”

Section: Tablementioning

confidence: 44%

Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India

Sachithanandham

Kannangai

Abraham³

et al. 2013

Intervirology

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“…This finding mirrors results from Italy, where KS risk was 5-fold higher in the first year after transplantation than in subsequent periods. 10,29 The rapid development of KS implicates immunosuppression as a major risk factor in the immediate posttransplant period. Perhaps, immunosuppressed recipients fail to control HHV-8 infection, leading to uncontrolled viral replication and/or expansion of tumor progenitor cells, and progression to KS.…”

Section: Discussionmentioning

confidence: 99%

Kaposi's sarcoma risk among transplant recipients in the United States (1993–2003)

Mbulaiteye¹,

Engels²

2006

Intl Journal of Cancer

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Kaposi's sarcoma (KS) risk is high in immunosuppressed transplant recipients. KS develops in recipients with pre‐existing infection with human herpesvirus 8 (HHV‐8), the causative agent for KS, but it can also occur in recipients infected by donors. The relative importance of these sources of infection in recipients in the United States is unknown. We report recipient and donor characteristics associated with KS among transplant recipients in the United States. KS risk, after solid organ transplantation during 1993–2003, was analyzed using data from the Organ Procurement and Tissue Network. Associations were determined using proportional hazards regression. Sixtyfive KS cases were identified among 234,127 transplants (incidence 8.8 per 100,000 person‐years). Most cases occurred in the first 2 years after transplantation (incidence 12.5 per 100,000 person‐years). KS risk increased steadily with recipient age (ptrend < 0.001) and was associated with the recipient being male (HR 1.8, 95% CI, 1.0–3.2), Hispanic (2.1, 1.1–3.8) and a non‐U.S. citizen (3.9, 1.8–8.6). Mismatch at the HLA‐B locus, but not at HLA‐A or HLA‐DR loci, was associated with heightened risk (HR 3.6, 95%CI 1.1–11 for 1–2 vs. 0 HLA‐B mismatches). KS was unrelated to donor characteristics and was not significantly related to use of specific antirejection medications. Our study found that KS incidence was low among transplant recipients in the United States, but it was associated with recipient age, sex and citizenship, perhaps reflecting pre‐existing HHV‐8 infection. The high KS risk immediately posttransplant and in persons with HLA‐B mismatch highlights the role of immunosuppression and/or immune stimulation in KS pathogenesis. © 2006 Wiley‐Liss, Inc.

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“…In transplant patients, increased immunosuppression often leads to viral recrudescence, producing an iatrogenic illness. Iatrogenic KS lesions usually develop in the first year following solid organ allografts due to pharmacological immunosuppression (23). In iatrogenic KS it has been proven that HHV-8 can be transplanted via an HHV-8-infected organ, blood transfusion from an HHV-8-positive donor or, as in our case, can preexist in the host in a latent state and manifest upon immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Iatrogenic Multicentric Castleman’s Disease Arising Due to Recrudescence of HHV-8 in a Liver Transplant Patient

Speicher

Sehu

Mollee

et al. 2014

American Journal of Transplantation

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We describe the case of a 59‐year‐old HIV‐negative male who developed multicentric Castleman's disease (MCD) 1 year postliver transplantation due to recrudescence of a pretransplant human herpesvirus‐8 (HHV‐8) infection. He presented with fevers, dry cough, weight loss and drenching night sweats. Routine investigations were all unremarkable. Computerized axial tomography (CT) scans showed splenomegaly and intra‐abdominal lymphadenopathy, confirmed by positron emission tomography. Cervical lymph node biopsies were consistent with MCD. The presence of HHV‐8 was confirmed on immunohistochemistry. Peripheral blood HHV‐8 quantitative polymerase chain reaction (qPCR) monitoring showed a threefold decrease in viremia in the first week of treatment with ganciclovir but had little impact on clinical symptoms. Reducing immunosuppression and switching to rituximab resolved clinical symptoms and produced a negative HHV‐8 qPCR result. Retrospective molecular testing of sera collected pre‐ and immediately posttransplantation confirmed preexisting HHV‐8 in the host. This is the first reported case of an HIV‐negative postliver transplant patient developing MCD that manifested as posttransplant lymphoproliferative disorder due to recrudescence of HHV‐8. We propose (1) the introduction of the term iatrogenic Castleman's disease (CD) for this and similar cases, (2) rituximab should be considered as a treatment option for CD and (3) consideration be given to a change to the World Health Organization classification of CD to incorporate such cases.

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Kaposi’s Sarcoma in Transplant and HIV-infected Patients: An Epidemiologic Study in Italy and France

Cited by 50 publications

References 14 publications

Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India

Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India

Kaposi's sarcoma risk among transplant recipients in the United States (1993–2003)

Successful Treatment of Iatrogenic Multicentric Castleman’s Disease Arising Due to Recrudescence of HHV-8 in a Liver Transplant Patient

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