Molecular evidence of organ-related transmission of Kaposi sarcoma–associated herpesvirus or human herpesvirus-8 in transplant patients

Abstract

In transplant patients, Kaposi sarcoma (KS)-associated herpesvirus or human herpesvirus-8 (HHV-8) infection is associated with the development of KS, primary effusion lymphoma and Castleman disease. Whether HHV-8 is either reactivated in the recipient or transmitted by the donor has been investigated so far only by serologic studies. Thus, we addressed the issue of HHV-8 transmission in the transplantation setting by molecular methods. We exploited the high level variability of the orf-K1 gene and the polymorphism of theorf-73 gene of the HHV-8 genome to assess the genetic relatedness of the HHV-8 strains identified in the posttransplant KS lesions that developed, simultaneously, 20 months after transplantation, in 2 recipients of twin kidneys from the same cadaver donor. The 100% identity of nucleotide sequence of the most variable viral region and the presence of the same, singleorf-73 type in both patients provides strong molecular evidence of organ-related transmission of HHV-8 in the setting of transplantation.

Human Herpesviruses 6, 7 and 8 in Solid Organ Transplant Recipients

“…HHV‐8 infection in SOT recipients may occur either as primary infection in HHV‐8 seronegative recipients of allografts from HHV‐8 seropositive donors or as secondary reactivation of latent virus . The incidence of HHV‐8 infection and associated malignancies in SOT recipients is variable depending on the geographic area and it mirrors the varied seroprevalence worldwide .…”

Human herpesvirus 8 genomes and seroprevalence in United States blood donors

“…Serology studies also indicated that HHV‐8 transmission occurs through solid organ, for example, kidney or liver, transplantation 10 . Molecular DNA analysis demonstrated HHV‐8 transmission through kidney transplantation 11 . What was not determined in these studies was whether viral transmission occurred through infected cells of the transplanted organ or via infected lymphocytes contained within the organ.…”

Seroprevalence of human herpes virus 8 antibody in populations at high or low risk of transfusion, graft, or sexual transmission of viruses

“…On the other hand, the risk of HHV‐8 transmission after organ transplantation is not well known. Organ graft recipients can develop KS when they are infected with HHV‐8, but it is unknown whether this is a result of reactivation of latent HHV‐8 or of HHV‐8 transmission through organ transplantation 16–18 …”