The Discovery of HHV-8 Kaposis sarcoma was one of the original clinical syndromes that led to the...
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The Discovery of HHV-8 • Kaposi’s sarcoma was one of the original clinical syndromes that led to the discovery of HIV • Thought for many years that the cause was infectious • The virus was discovered in 1994 by Yuan Chang and colleagues at Columbia University • Belongs to a family of viruses which cause cancer known as the gammaherpesvirus family
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Transcript of The Discovery of HHV-8 Kaposis sarcoma was one of the original clinical syndromes that led to the...
The Discovery of HHV-8
• Kaposi’s sarcoma was one of the original clinical syndromes that led to the discovery of HIV
• Thought for many years that the cause was infectious
• The virus was discovered in 1994 by Yuan Chang and colleagues at Columbia University
• Belongs to a family of viruses which cause cancer known as the gammaherpesvirus family
How is HHV-8 Transmitted ? Sexual Transmission
HHV-8 infection has been linked to a history of various Sexually Transmitted Diseases
No specific sexual behavior that results in infection has been identified
Mother to Child In Africa, infections are rare before age two, but the number of
infections in puberty is identical to adult prevalence. This suggests that children may get HHV-8 from their family
Transmission through Blood Transmission through Saliva
High seroprevalence of antibodies to HHV-8 in Egyptian children: evidence of
non-sexual transmission
010
20
30
40
50
60
70
8090
100
<1 1-3 4-6 7-9 10-12 >12
EBV
010
20
30
40
50
60
70
8090
100
<1 1-3 4-6 7-9 10-12 >12
CMV
010
20
30
40
50
60
70
8090
100
<1 1-3 4-6 7-9 10-12 >12
HHV-6
Years
010
20
30
40
50
60
70
8090
100
<1 1-3 4-6 7-9 10-12 >12
HHV-8
YearsAndreoni. J nat cancer Inst. 1999
The clinical disease that is classically associated with HHV-8 infection is KS and less commonly Castleman’s disease and primary effusion lymphoma (PEL). These HHV-8-associated diseases occur most commonly among immunocompromised patients, such as HIV-infected patients, those with end-stage renal disease, and transplant recipients. In the United States, the incidence of transplant associated KS is 10 to 20 times higher than the general population
The natural history of human herpesvirus 8 infection: clinical stages and determinants of progression.
Progression to KS stratified by HHV8 Progression to KS stratified by HHV8 antibody titersantibody titers
HHV8 negativeHHV8 negative
0.00.0
0.10.1
0.20.2
0.30.3
0.40.4
0.50.5
0.60.6
0.70.7
0.80.8
0.90.9
1.01.0
00 11 22 33 44 55 66 77 88 99 1010
HHV8 antibodyHHV8 antibody
titers (1:125)titers (1:125)
HHV8 antibodyHHV8 antibody
titers (1:5 to 1:25)titers (1:5 to 1:25)
years from seroconversionyears from seroconversion
Ris
k o
f K
ap
osi’
s
Sarc
om
a
Adjusted RH 51.8
Adjusted RH 24.8
Rezza G, Journal of National Cancer Institute, 1999
Manifestazioni cliniche dell’infezione primaria di HHV8
nell’immunocompromesso• Febbre, artralgia, linfoadenopatia (iperplasia angiolinfoide),
splenomegalia e citopenia. HIV+ (Oksehendler NEJM 1998)
• Febbre, splenomegalia, pancitopenia. 2 trapiantati rene HHV-8 negativi. (Luppi NEJM 2000)
• Multiorgan failure. Bambina di un mese con S. Di George (Sanchez-Velasco, JID 2001)
• Febbre, sudorazioni, linfoadenopatia, epatite (Marcelin AIDS, 2000)
• Diarrea, linfoadenopatia rash. 5 omosessuali HIV negativi (Wang, Blood 2001)
• Esantema maculopapulare e artrite. Donna con artrite reumatoide (Herpesvirus infections, Parigi 2001)
