ABSTRACT
La enfermedad de Castleman (EC) es un proceso linfoproliferativo poco frecuente que se caracteriza por hiperplasia de los ganglios linfáticos. Existen dos variedades histológicas bien diferenciadas la hialino-vascular y la plasmocelular, que a su vez pueden ser localizadas o multicéntricas. La forma hialino-vascular suele ser asintomática y localizada en mediastino mientras que la plasmocelular se presenta frecuentemente con signo-sintomatología sistémica y suele ser difusa o multicéntrica. En el contexto de la enfermedad debida al virus de la inmunodeficiencia humana (VIH), la EC se asocia en su patogenia a la infección por el herpes virus humano tipo-8 (HHV-8). La mayoría de los casos corresponden a la variante hialino-vascular (80/90%) en tanto un pequeño porcentaje (10/20%) son de la variante plasmocelular. En algunos pacientes, el patrón histopatológico puede ser mixto. Se describen dos casos de enfermedad de Castleman multicéntrica HHV8- positiva en pacientes con enfermedad HIV/SIDA.
Castleman's disease (CD), is a rare hematological condition of uncertain etiology, involves a massive proliferation of lymphoid tissues and typically presents as mediastinal masses. This is considered as a distinct type of lymphoproliferative disorder associated with inflammatory symptoms. In the context of human immunodeficiency virus (HIV) infection, CD is associated with human herpesvirus-8 (HHV8) infection. Most cases of CD represent either the hyaline vascular variant (8090% of cases) or the plasma cell variant (1020%); a small percentage present with a mixed histologic appearance. Two cases of Castleman's disease associated with HHV-8 and HIV/AIDS infection are described
Subject(s)
Humans , Male , Middle Aged , Aged , Castleman Disease/pathology , Castleman Disease/therapy , AIDS-Related Opportunistic Infections/immunology , Herpesvirus 8, Human/immunology , HIV TestingABSTRACT
Objective To investigate the status of carcinogenic infection in people infected with HIV and those with negative HIV test results in VCT clinics. To analyze the epidemiological characteristics and provide scientific basis for more targeted disease prevention and control strategies. Methods The serum levels of Epstein-Barr virus （EBV）， human herpesvirus type 8 （HHV-8） and human T-lymphotropic virus type Ⅰ （HTLV-Ⅰ） antibodies were detected by ELISA method in 224 HIV-infected patients and 480 HIV-negative visitors treated in VCT clinics during the same period from 2014 to 2017， to compare the differences in the infection rates of this virus between HIV-infected and HIV-negative individuals and to systematically analyze the correlation between viral infections and high-risk sexual behavior. Results Among the 224 HIV-infected patients， 79 were positive for EBV antibody， with the infection rate of 35.27%； 151 were positive for HHV-8 antibody， with the infection rate of 67.41%； and 95 were positive for HTLV-Ⅰ， with the infection rate of 42.41%. A total of 480 HIV negative visitors were tested. 7 patients were positive for EBV antibody， with the infection rate of 1.46%. 26 patients were infected with positive HHV-8 antibody， with the infection rate of 5.41%. 9 patients had positive HTIV-Ⅰ antibody， with the infection rate of 1.86%. The infection rates of the three carcinogenic viruses in HIV-infected patients were all higher than those in HIV-negative groups， and the differences were statistically significant （ P <0.05）. Conclusion There is a high prevalence of three highly carcinogenic viruses in HIV-infected patients and serious co-infection. It is necessary to improve the education of safe sex among HIV-infected patients and people with high risk of infection in order to curb the epidemic of HIV and other infectious diseases.
ABSTRACT
Objective To investigate the status of carcinogenic infection in people infected with HIV and those with negative HIV test results in VCT clinics. To analyze the epidemiological characteristics and provide scientific basis for more targeted disease prevention and control strategies. Methods The serum levels of Epstein-Barr virus （EBV）， human herpesvirus type 8 （HHV-8） and human T-lymphotropic virus type Ⅰ （HTLV-Ⅰ） antibodies were detected by ELISA method in 224 HIV-infected patients and 480 HIV-negative visitors treated in VCT clinics during the same period from 2014 to 2017， to compare the differences in the infection rates of this virus between HIV-infected and HIV-negative individuals and to systematically analyze the correlation between viral infections and high-risk sexual behavior. Results Among the 224 HIV-infected patients， 79 were positive for EBV antibody， with the infection rate of 35.27%； 151 were positive for HHV-8 antibody， with the infection rate of 67.41%； and 95 were positive for HTLV-Ⅰ， with the infection rate of 42.41%. A total of 480 HIV negative visitors were tested. 7 patients were positive for EBV antibody， with the infection rate of 1.46%. 26 patients were infected with positive HHV-8 antibody， with the infection rate of 5.41%. 9 patients had positive HTIV-Ⅰ antibody， with the infection rate of 1.86%. The infection rates of the three carcinogenic viruses in HIV-infected patients were all higher than those in HIV-negative groups， and the differences were statistically significant （ P <0.05）. Conclusion There is a high prevalence of three highly carcinogenic viruses in HIV-infected patients and serious co-infection. It is necessary to improve the education of safe sex among HIV-infected patients and people with high risk of infection in order to curb the epidemic of HIV and other infectious diseases.
ABSTRACT
La enfermedad de Castleman (ECM) es un desorden linfoproliferativo y con un pronóstico desfavorable, que se lo ha asociado a la infección por el virus herpes humano tipo 8 (HHV-8). El mecanismo supuesto de ac-ción del HHV-8 sería la secreción de interleuquinas (IL) virales, homólo-gas a IL humanas tales como IL-6 e IL-10. La coinfección por HHV-8 y vi-rus Epstein Barr (EBV) es bien conocida en pacientes con infección por el virus de la inmunodeficiencia humana tipo 1 (HIV-1). Estos gamma-herpesvirus se asocian a trastornos linfoproliferativos que son favore-cidos por la inmunosupresión. Puede presentarse en el contexto de un buen estado inmunológico y su tratamiento se basa en el uso de quimioterapia. La reactivación del EBV latente es favorecida por la infección por HIV-1 y el uso de drogas inmunosupresoras, determinando un potencial riesgo para el desarrollo de nuevos desór-denes linfoproliferativos. Se presenta el caso de un paciente con enferme-dad de Castleman asociado a la infección por HIV-1 y HHV-8, que presentó como complicación post-qui-mioterapia reactivación de infección EBV. Se realizó una revisión del concepto de ECM y la relación pato-génica entre los virus HIV-1, HHV-8 y EBV
Castleman's disease (CD) is a lymphoproliferative disorder with an unfavorable prognosis, which has been associated with human herpes virus 8 (HHV-8) infection. The presumed mechanism of action of HHV-8 would be the secretion of viral interleukin (IL), homologous to human IL such as IL-6 and IL-10. The co-HHV8 infection and Epstein Barr virus (EBV) is well known in patients infected with the HIV type 1 (HIV-1). These gamma-herpesvirus were associated with lymphoproliferative disorders that are favored by immunosuppression. It can occur in the context of a patient's good immune system and its treatment is based on the use of chemotherapy. Reactivation of latent EBV is favored by HIV-1 and the use of immunosuppressive drugs, determining a potential risk for the development of new lymphoproliferative disorders.We report here a patient with Castleman's disease associated with HIV-1 and HHV-8, who presented, as a complication of the chemotherapy, the reactivation of EBV infection. A review of the concept of CD and the pathogenic relationship between HIV-1, HHV-8 and EBV virus was performed
Subject(s)
Humans , Male , Middle Aged , HIV Infections/therapy , Castleman Disease/therapy , Herpesvirus 8, Human , Epstein-Barr Virus Infections/therapyABSTRACT
La enfermedad de Castleman es un desorden linfoprolifera-tivo de origen aún incierto pero, en principio, relacionado con una dis-función de las células dendríticas foliculares y con una producción al-terada de distintas citoquinas, la mayor parte de ellas con actividad proinflamatoria y responsable de la sintomatología que presentan los pacientes.La relación con la presencia del HHV8, especialmente de las formas graves, ha sido ampliamente documentada en los últimos años y su desarrollo en el marco de la infección por el HIV permite una evolu-ción desafortunada de esta asociación morbosa presentando una ten-dencia importante hacia el desarrollo de patologías neoplásicas tales como la enfermedad de Kaposi y distintos tipos de linfomas.Se presentan dos casos de enfermedad de Castleman asociados a in-fección por HIV y HHV8 y se describe el contexto patogénico donde se desarrollan
Castleman Ìs disease is a lymphoproliferative disorder of uncertain origin but, principally, related to dysfunction of follicular dendritic cells and impaired production of various cytokines, most of which have proinflammatory activity and are responsible for the symptoms that patients present.The relationship between Castleman Ìs disease and HHV8, especially in severe forms, has been well documented in the last years. This morbid association is related to an unfortunate evolution in the context of HIV infection, presenting an increased risk of neoplastic disorders such as Kaposi Ìs disease and various types of lymphomas.Two cases of Castleman Ìs disease associated with HHV8 and HIV infection, and the pathogenic context in which they developed, are presented and described
Subject(s)
Humans , Male , Adult , Middle Aged , HIV Infections/therapy , Castleman Disease/diagnosis , Herpesvirus 8, Human/immunologyABSTRACT
Aims: We present this case to report clinical knowledge about unusual feature of classic Kaposi sarcoma in Korea. Presentation of Case: We report on a case involving an unusual clinical feature of a 76- year-old HIV-seronegative, HHV-8 infected Korean male, which was histologically confirmed as cutaneous Kaposi sarcoma (KS) on the ankle and foot dorsum. Discussion: KS is an intermediate-grade angioproliferative neoplasm derived from lymphatic endothelium in association with AIDS and human herpes virus 8 (HHV-8) infections. The tumor does not commonly affect non-HIV infected persons. Development of the disease occurs through the complicated interplay of HHV-8 with genetic, immunologic, and environmental factors. We discuss several risk factors presenting in most patients but were not observed in this patient, who did not fit easily into any of the well-known subtypes. Conclusion: Diagnosis of KS is often not possible solely on the basis of morphological characteristics. Based on our review of the literature, this is a sporadic case of classic KS according to its unusual clinical features.
ABSTRACT
Objective To construct the prokaryotic expression plasmid of HHV-8 fusion antigen for diagnosis of HHV-8 infec-tion .Methods The combined fragment ORF59 ,ORF65 and K8 .1 by fusion PCR was integrated into pQE-80L and transfected into E .coli DH5α.Fusion protein was induced to express by IPTG .SDS-PAGE and Western blot were employed to detect the fusion protein .Fusion protein was used to detect serum of blood donors .Results The combined plasmid pQE-80L-ORF59-ORF65-K8 .1 was constructed successfully after verifying by restriction enzyme digestion and sequencing .The fusion protein was about 24 KD and could be specific combined with HHV-8 positive serum .The fusion protein had the same result to detect HHV-8 with the HHV-8 ELISA kit .Conclusion Fusion protein we construct can be used as diagnosis antigen to detect HHV-8 of blood donors and common people .
ABSTRACT
The number of patients diagnosed with Kaposi's sarcoma has grown steadily since it was first discovered in 1972 by Moric Kaposi, a Hungarian dermatologist. Kaposi's sarcoma can be classified into four subtypes according to clinical form, epidemiology, and prognosis: idiopathic, endemic or African, immunosuppresion related, and acquired immunodeficiency syndrome related or epidemic Kaposi's sarcoma. A single idiopathic Kaposi's sarcoma in the head and neck area is very rarely found in an immunocompetent person. We experienced a case of Kaposi's sarcoma of the oropharynx and hypopharynx. The patient was healthy 70-year-old man and had no signs of being human immunodeficiency virus positive or immunocompromised. The patient was treated with inductive chemotherapy using capecitabine (Xeloda(R))/cisplatin followed by radiotherapy to a total 54 Gy.
Subject(s)
Aged , Humans , Acquired Immunodeficiency Syndrome , Deoxycytidine , Fluorouracil , Head , Herpesvirus 8, Human , HIV , Hypopharynx , Neck , Oropharynx , Sarcoma, Kaposi , CapecitabineABSTRACT
Self-regression of Kaposi's sarcoma is rare with the exception of the iatrogenic immunosuppressive type. No cases of classic type Kaposi's sarcoma showing spontaneous regression have been reported in the Korean dermatologic literature. We report a case of classic type of Kaposi's sarcoma in a 69-year-old man which followed a clinical course of spontaneous regression. He presented with multiple asymptomatic beefy red papules and nodules scattered on both cheeks and upper extremities during a state of increase in the number of skin lesions at the initial visit. He had no history of immunosuppressive treatment and the laboratory findings were unremarkable. An anti-HIV antibody test was negative. A histopathologic examination revealed typical findings of Kaposi's sarcoma and positive staining with CD31 and D2-40. HHV-8 DNA was detected in a biopsy specimen. Without any specific treatment, the skin lesions healed without leaving any complications after 15 months, and did not show any evidence of recurrence during the ensuing 5 years.
Subject(s)
Aged , Humans , Biopsy , Cheek , DNA , Herpesvirus 8, Human , Recurrence , Sarcoma, Kaposi , Skin , Upper ExtremityABSTRACT
Los linfomas no Hodgkin (LNH) constituyen la segunda neoplasia definitoria de Sida más frecuente. En el presente trabajo se evaluaron 48 casos de linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana (HIV) diagnosticados en la División Histopatología del Instituto de Investigaciones Hematológicas de la Academia Nacional de Medicina. Se incluyeron en la investigación 5 mujeres y 43 hombres con una mediana de edad al momento del diagnóstico de la neoplasia de 37 años. La evaluación morfológica se realizó en cortes coloreados con hematoxilina-eosina, estudio inmunohistoquímico para la detección del virus de Epstein Barr (VEB) en 48/48 casos, y mediante sonda oligonucleotídica biotinilada para la detección del ADN del Herpes virus humano tipo-8 (HHV-8) en 14/14 linfomas plasmoblásticos (LP). Todos fueron linfomas de fenotipo B, con un curso clínico agresivo y enfermedad neoplásica avanzada al momento del diagnóstico. Se pudo demostrar la fuerte asociación del VEB con los linfomas asociados al sida, con frecuencias que variaron según el subtipo histológico: 16/21 (76%) para los linfomas difusos de grandes células; 1/3 casos (33%) de linfomas de Burkitt y 3/4 (75%) en los linfomas primarios del sistema nervioso central. Globalmente, el genoma del VEB se detectó en 20/28 (71%) de las muestras de biopsias de LNH de esta serie. La detección del HHV-8 resultó negativa en los 14 LP. Los linfomas de Hodgkin fueron más frecuentes en varones,18/20 (90%), con un curso clínico agresivo y franco predominio de los subtipos histológicos de peor pronóstico (90% de casos). En estas neoplasias también se comprobó una frecuente asociación patogénica con el VEB (90% de casos).
Non-Hodgkin lymphomas (NHL) of the B-cell type are the second most common neoplasm among patients with human immunodeficiency virus (HIV) infection and AIDS. Here, we evaluated 48 cases of AIDS-related lymphomas (ARL) diagnosed at the Histopathological Division of the Instituto de Investigaciones Hematológicas of the National Academy of Medicine. Five were females and 43 were males with a median of age of 37 years at the time of the diagnosis. Micrometer sections were prepared and stained with hematoxilin-eosin; immunohistochemical examination for the presence of Epstein-Barr virus (EBV) was carried out in 48/48 cases. Additionally, biotinilated oligonucleotides were used to determine the presence of DNA of the Human Herpes virus type-8 (HHV-8) in 14/14 biopsy smears corresponding to plasmablastic lymphomas (PL). All were fenotype B cell lymphomas with an aggressive course and advanced neoplasm disease at the time of diagnosis. Virological findings showed the strong association between EBV and AIDS-related NHL. According to the histopathological subtype, the EBV genome was detected in 16/21 (76%) diffuse large B cell lymphomas, 1/3 Burkitt lymphoma and 3/4 (75%) of primary central nervous system lymphomas. Globally, EBV genome was detected in 20/28 NHL of this series. Detection of HHV-8 was negative in all cases of PL. Hodgkin lymphoma were more frequent in males 18/20 (90%), with an aggressive clinical course and a significant predominance of the subtypes associated with worse prognosis (90% of cases). We detected a significant association between EBV and HL (90% of cases). We consider that all cases of AIDS related lymphomas should be assessed for the presence of EBV because its presence may play a role in the prognosis.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , DNA, Viral/analysis , /genetics , Hodgkin Disease/virology , Lymphoma, AIDS-Related/virology , Lymphoma, Non-Hodgkin/virology , Hodgkin Disease/pathology , Immunohistochemistry , In Situ Hybridization , Lymphoma, AIDS-Related/classification , Lymphoma, AIDS-Related/pathology , Lymphoma, Non-Hodgkin/pathology , Risk FactorsABSTRACT
Kaposi's sarcoma (KS) is an unusual multifocal neoplasm of vascular endothelial cell origin. The trunk, arms, head, and neck are the most common sites. It is common in men and has four distinct variants: classic, Africa-endemic, immunosuppressive drug-associated, and acquired immunodeficiency syndrome-associated KS. KS appears to develop immunosuppressed patients, but is uncommon in patients on dialysis. A 79-year-old man on hemodialysis for 2 months presented with pruritus over the entire body and multiple, discrete, variable-sized, dark blue papulonodules (papuloplaques, maculopapules) on the left arm and shoulder. A biopsy specimen form the left arm showed spindle cells with slit-like spaces and extravasated red blood cells. The specimen was positive for CD 34 antigen, and human herpesvirus 8 was detected. We report a case of KS that occurred in a 79-year-old patient on hemodialysis.
Subject(s)
Aged , Humans , Male , Arm , Biopsy , Dialysis , Endothelial Cells , Erythrocytes , Head , Herpesvirus 8, Human , Neck , Pruritus , Renal Dialysis , Sarcoma, Kaposi , ShoulderABSTRACT
Human herpesvirus 8 (HHV-8), the etiological agent of Kaposi's sarcoma (KS), is endemic in parts of the sub-Saharan, and KS has increased concomitantly with the HIV/AIDS epidemic. In Mozambique (MZ), no data concerning HHV-8 infection was available, thus the main of this work was to investigate, for the first time, the presence of HHV-8 infection in Maputo, MZ. Latent and lytic HHV-8-specific antibodies were assessed in blood samples from 189 individuals from the Central Hospital of Maputo, MZ, using "in-house" immunofluorescence assays conducted in São Paulo, Brazil. The results obtained were analyzed according to socio-demographic and clinical variables using the Chi-square test and logistic regression. An HHV-8 seropositivity of 1.8 percent and 9.7 percent was detected among 57 medical students and 31 individuals from the staff, respectively, in contrast to 16.4 percent detected among 67 out-patients. Concerning 34 hospitalized patients from the Dermatology Unit, 47.1 percent were HHV-8-seropositive overall, while the rate was 85.7 percent among KS patients. The present survey, conducted in Maputo, MZ, demonstrates great variation in HHV-8 infection frequencies depending on the group analyzed and epidemiological variables. An association between HHV-8 seropositivity and male gender (OR 5.72), the central origin of patients (OR 5.33), blood transfusions (OR 3.25), and KS (OR 24.0) was detected among hospitalized patients, and primary school (OR 7.18) and HIV-1 infection (OR 8.76) among out-patients.
Subject(s)
Female , Humans , Male , Antibodies, Viral/blood , Herpesviridae Infections/epidemiology , /isolation & purification , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/epidemiology , AIDS-Related Opportunistic Infections/virology , Fluorescent Antibody Technique , Herpesviridae Infections/diagnosis , /immunology , Mozambique/epidemiology , Risk Factors , Socioeconomic FactorsABSTRACT
O Herpesvírus 8 humano (HHV-8) é endêmico em populações africanas e indígenas da região Amazônica. A infecção nestas populações acontece durante a infância e, na África, envolve o contato íntimo no ambiente intrafamiliar. Diversos estudos confirmam a distribuição geográfica dos diferentes subtipos de HHV-8, sendo que o subtipo E é típico das populações indígenas. Objetivos: 1. Caracterizar o(s) subtipo(s) de HHV-8 que circula(m) em população indígena da Amazônia brasileira baseado na análise da região ORF K1 do vírus; 2. Construir a árvore filogenética dos subtipos virais encontrados; 3. Comparar filogeneticamente os subtipos encontrados com os subtipos prevalentes em outras populações indígenas do Brasil e de outros países da América do Sul; 4. Calcular a taxa de substituição para a região VR1 do HHV-8 para as amostras estudadas; 5. Estimar a data de entrada do vírus na população do estudo; 6. Investigar a dinâmica de transmissão do vírus no ambiente intrafamiliar; 7. Averiguar se há correlação entre os alelos de HLA classe I (A e B) e II (DQB1 e DRB1) e suscetibilidade à infecção por HHV-8. Casuística e métodos: Estudo de soroprevalência da infecção por HHV-8 em amostra de população indígena da Amazônia brasileira utilizando IFI para detecção de antígenos da fase latente (LANA) e lítica (Lítico) do vírus. Análise filogenética da amostras encontradas utilizando-se o DNA/HHV-8 extraído de amostras de saliva, submetidas à reação de nested PCR para amplificar as regiões hipervariáveis VR1 e VR2. Cálculo da taxa de substituição do HHV-8, utilizando-se os métodos de distância e técnica bayesiana. Estimar a data do ancestral comum mais recente para as amostras em estudo, utilizando-se o programa BEAST. Tipagem de HLA de indivíduos positivos e negativos para a infecção por HHV-8, utilizando-se a técnica de PCR-SSO. Resultados: A soroprevalência geral da infecção por HHV-8 na população em estudo foi de 75,3% (399/530). Observou-se que a soropositividade...
The human herpesvirus 8 (HHV-8) is endemic in Africa and Amerindian populations from Amazon region. The infection in those populations occurs during childhood and, in Africa, involves a close contact in intrafamilial environment. Several studies confirm the geographical distribution of different subtypes of HHV-8, and the subtype E is typical of the Amerindian population. Objectives: 1. To characterize the HHV-8 subtypes circulating in Amerindian population from Brazilian Amazon, based on the analysis of ORF K1 region of the virus. 2. To construct a phylogenetic tree of viral subtypes found among Amerindians 3. To compare by phylogenetic methods the subtypes found in Mapuera Amerindians with the subtypes prevalent in others Amerindians populations of Brazil and South America 4. To determine the substitution rate of VR1 region of HHV-8 for the sequences obtained in the present study 5. To estimate the date of entry of the viruses in the Mapuera population 6. To investigate the dynamic of transmission of the virus in the intrafamilial environment 7. To investigate if there is a correlation between susceptibility to HHV-8-infection and HLA class I (A and B) and II (DQB1 and DRB1) alleles. Patients and methods: The seroprevalence of HHV-8 infection in a sample of the indigenous population of the Brazilian Amazon was carried out using IFA to detect antibodies to latent (LANA) and lytic phase antigens of HHV-8. Phylogenetic analysis of the sequences was performed by using the DNA extracted from samples of saliva, using a nested PCR to amplify the hypervariable regions VR1/ VR2 of HHV-8. Estimation of the substitution rate of HHV-8 nucleotides was performed by using the method of distance and the Bayesian technique. Estimates of the time of the most recent common ancestor (TMRCA) for all samples studied were done by using the BEAST program. HLA typing of positive and negative subjects for HHV-8 infection was performed by using the PCR-SSO technique...
Subject(s)
Humans , Male , Female , Biological Evolution , Histocompatibility Testing , Indigenous Peoples , Molecular Epidemiology , Seroepidemiologic StudiesABSTRACT
Human herpesvirus-8 (HHV-8) also referred to as Kaposi’s sarcoma-associated herpes-virus (KSHV),is a novel tumor causing virus,which is thought to be the etiologic agent of KS,and also is associated with primary effusion lymphoma(PEL) and multicentric castleman’s disease(MCD) HHV-8 encodes a number of viral proteins, including the proteins associated with HHV-8 latent infection and lytic infection,and the proteins unique to HHV-8,which are critical players in the development of KS and HHV-8-associated diseases. The proteins encoded by HHV-8 and association between HHV-8 and KS were reviewed.
ABSTRACT
BACKGROUND: Kaposi's sarcoma (KS) is a vascular neoplasm that was rarely seen before the AIDS and transplantation era. The isolation of human herpesvirus 8 (HHV-8) in all forms of KS strongly suggests a role of this agent in the pathogenesis. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features of KS and assess the presence of HHV-8 sequences in Korea. METHODS: The medical records and histopathologic slides of patients with KS, who were diagnosed at Asan Medical Center from 1989 to 2005, were reviewed. We also performed polymerase chain reaction (PCR) to find out the presence of HHV-8. RESULTS: 1.Among the 22 patients, classic KS was found in 9 and iatrogenic immunosuppressive-associated KS in 13 patients. 2.Clinical features were varied, usually limiting to the skin of the extremities, however, involvement of internal organs and mucosa was also detected. 3. The histology of cutaneous lesions associated with various clinical forms of KS was essentially identical, however, it presented different features according to their stage. 4. HHV-8 sequences were identified in all cases of KS, including the lesions of internal organs. 5.Classic KS responded well to radiation therapy, thalidomide or chemotherapy, except 2 patients. Iatrogenic immunosuppressive KS improved generally after radiation therapy, IFN-alpha, or chemotherapy, but some of the patients died due to underlying diseases. CONCLUSION: KS is a rare vascular neoplasm. We retrospectively studied twenty-two cases, and HHV-8 were detected in all cases, these supporting HHV-8 as the causative agent.
Subject(s)
Humans , Drug Therapy , Extremities , Herpesvirus 8, Human , Korea , Medical Records , Mucous Membrane , Polymerase Chain Reaction , Retrospective Studies , Sarcoma, Kaposi , Skin , Thalidomide , Vascular NeoplasmsABSTRACT
BACKGROUND: Kaposi's sarcoma (KS) is a mesenchymal tumor involving blood and lymphatic vessels. Viral oncogenesis by human herpesvirus 8 (HHV8) and cytokine-induced growth together with some state of immunocompromise represent important conditions for this tumor to develop. OBJECTIVE: The purpose of this study was to document the clinical and histopathological features of KS in Korea. METHODS: The medical records and histopathologic slides of patients with KS diagnosed at Yonsei University Medical Center from January, 1992 to March, 2003 were reviewed. We used immunohistochemical stains for HHV8 to determine whether HHV8 is present in KS. RESULTS: Among the 21 patients, classic KS was found in 7, acquired immunodeficiency syndrome (AIDS)-associated KS in 3, and iatrogenic, immunosuppressive KS in 11. Classic and iatrogenic KS most often have a preference for the lower extremities, while the upper body in AIDS-KS. Mucosal involvement and systemic organ involvement could be detected in AIDS-KS. Immunohistochemical stains for HHV8 were positive in 100% with classic KS and AIDS?KS, and 90.9% with immunosuppressive KS. Classic KS responded well to local therapy and showed indolent course. Iatrogenic, immunosuppressive KS generally regressed after reduction or cessation of immunosuppressive drug therapy, but some of them showed resistance to therapy. For AIDS-KS, no systemic treatments have been shown to prolong survival. CONCLUSION: Because classic KS and iatrogenic, immunosuppressive KS generally have a benign course, cautions are taken not to overtreat them. However, some cases of organ transplantation associated KS have an aggressive course, prompting us to consider active treatments to save transplanted organ.
Subject(s)
Humans , Academic Medical Centers , Acquired Immunodeficiency Syndrome , Carcinogenesis , Coloring Agents , Drug Therapy , Herpesvirus 8, Human , Korea , Lower Extremity , Lymphatic Vessels , Medical Records , Organ Transplantation , Sarcoma, Kaposi , TransplantsABSTRACT
BACKGROUND: The association of Kaposi's sarcoma-associated human herpesvirus, or human herpesvirus 8 (HHV8) with various skin diseases has been described in many reports. However, only 3 human diseases: Kaposi's sarcoma, primary effusion lymphoma, and multicentric Castleman disease were proved to be associated with HHV8. In addition to Karposi's sarcoma, sarcoidosis and Kikuchi's disease were also described to be associated with HHV8. OBJECTIVE: The purpose of this study was aimed at the association of HHV8 with various skin diseases, such as Kaposi's sarcoma, sarcoidosis, and Kikuchi's disease. METHODS: We performed PCR to examine whether the 233-bp segment of the viral DNA of HHV8 was detected in Korean patients with Kaposi's sarcoma, sarcoidosis, Kikuchi's disease, angiosarcoma, and angiolymphoid hyperplasia with eosinophilia. The medical records and histopathological specimens of patients diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. RESULTS: HHV8 DNA sequences were identified in 9 (69%) of sarcoid tissues from 12 patients with sarcoidosis and in all (100%) of from 8 patients with Kaposi's sarcoma but not in 2 tissues from 2 patients with Kikuchi's disease, in 3 tissues from 2 patients with angiosarcoma and 2 tissues from 2 patients with angiolymphoid hyperplasia with eosinophilia. CONCLUSION: HHV8 may be strongly associated with the pathogenesis of Kaposi's sarcoma and sarcoidosis. However, the association with Kikuchi's disease, angiosarcoma, and angiolymphoid hyperplasia with eosinophilia was denied in this study. Further extensive study will be needed.
Subject(s)
Humans , Angiolymphoid Hyperplasia with Eosinophilia , Base Sequence , DNA, Viral , Castleman Disease , Hemangiosarcoma , Herpesvirus 8, Human , Histiocytic Necrotizing Lymphadenitis , Lymphoma, Primary Effusion , Medical Records , Polymerase Chain Reaction , Sarcoidosis , Sarcoma , Sarcoma, Kaposi , Skin DiseasesABSTRACT
Kaposi's sarcoma(KS) occurs in four distinct subsets: classic, African-endemic, iatrogenic immunosuppressive drug-associated, and AIDS-associated KS. Only two cases of AIDS-associated KS have been reported in Korea. The pathogenesis remains unclear but, suggested the relevance to the association of virus infection with KS, especially human herpesvirus-8. We report a case of an AIDS-related KS that human herpesvirus-8 DNA is present in the KS tissue. The patient was diagnosed with AIDS in 1993 and had complained of disseminated erythematous to purplish colored papulonodules on the face, neck, chest and back for 5months. He was treated with systemic cytotoxic chemotherapy, but died due to septic condition.
Subject(s)
Humans , DNA , Drug Therapy , Herpesvirus 8, Human , Korea , Neck , Sarcoma, Kaposi , ThoraxABSTRACT
No abstract available.