Human herpesvirus 8 (HHV-8) detected by nested polymerase chain reaction (PCR) in HIV patients with or without Kaposi's sarcoma. An analytic cross-sectional study

Abstract

CONTEXT AND OBJECTIVE: Kaposi's sarcoma (KS) is a common neoplastic disease in AIDS patients. The aim of this study was to evaluate the frequency of human herpesvirus 8 (HHV-8) infection in human immunodeficiency virus (HIV)-infected patients, with or without KS manifestations and correlate HHV-8 detection with KS staging. DESIGN AND SETTING: Analytic cross-sectional study conducted in a public tertiary-level university hospital in Ribeirão Preto, São Paulo, Brazil. METHODS: Antibodies against HHV-8 lytic-phase antigens were detected by means of the immunofluorescence assay. HHV-8 DNA was detected in the patient samples through a nested polymerase chain reaction (nested PCR) that amplified a region of open reading frame (ORF)-26 of HHV-8. RESULTS: Anti-HHV-8 antibodies were detected in 30% of non-KS patients and 100% of patients with KS. Furthermore, the HHV-8 DNA detection rates observed in HIV-positive patients with KS were 42.8% in serum, 95.4% in blood samples and 100% in skin biopsies; and in patients without KS, the detection rate was 4% in serum. Out of the 16 serum samples from patients with KS-AIDS who were classified as stage II, two were positive (12.5%); and out of the 33 samples from patients in stage IV, 19 (57.6%) were positive. CONCLUSION: We observed an association between HHV-8 detection and disease staging, which was higher in the serum of patients in stage IV. This suggests that detection of HHV-8 DNA in serum could be very useful for clinical assessment of patients with KS and for monitoring disease progression.

Detection of Human Herpes Virus 8 in Kaposi’s sarcoma tissues at the University Teaching Hospital, Lusaka, Zambia

“…The higher (93%) HHV-8 prevalence among KS cases compared to non-KS tumours and reactive lesions in a study conducted in Tanzania support a causal relationship between the virus and primary KS [ 14 ]. Detection of HHV-8 by means of PCR is important for making differential diagnosis of KS, and can be used for the confirmation of histopathological diagnosis especially in cases of early vascular lesions which are difficult to diagnose [ 22 ]. Epidemiological studies have indicated that HHV-8 seropositivity in various populations is strongly correlated with the population's risk of developing KS [ 22 , 23 ].…”

“…Detection of HHV-8 by means of PCR is important for making differential diagnosis of KS, and can be used for the confirmation of histopathological diagnosis especially in cases of early vascular lesions which are difficult to diagnose [ 22 ]. Epidemiological studies have indicated that HHV-8 seropositivity in various populations is strongly correlated with the population's risk of developing KS [ 22 , 23 ]. In this study, three histological types of KS were identified: patch, plaque and nodular types.…”

“…The similarities in the two studies can be attributed to the fact that both countries are in the endemic region of KS where such results are expected. It could also be attributed to misdiagnosis at an early stage of the disease as the lesions are easily identified at an advanced stage or it may be that patients report to the hospital when the disease reaches an advanced stage [ 22 ].…”

“…Tumour biopsies are a convenient source of viral DNA as they have a high viral load compared to peripheral blood [ 4 ]. A recent study employing nested PCR to evaluate the frequency of HHV-8 infection in HIV infected patients with and without KS manifestations in Brazil detected HHV-8 DNA in 100% (13/13) of the tissues analysed [ 22 ]. This was attributable to the pathogenic role of HHV-8 in KS.…”

The Prevalence of Human Herpes Virus Type 8 in Semen Specimens of HIV-Negative Iranian Population Detected by Nested Polymerase Chain Reaction

“…HHV-8 interferes with the human immune system and prevents the normal function of the immune system, which appears to be the virus's mechanism of action (7,8). For example, infected B-lymphocytes cannot stimulate T lymphocytes, and nor can infected lymphocytic cells stimulate apoptotic viruses (8,9). In this way, the virus will be able to survive long-term in human endothelial cells and epithelial cells and continue to grow and proliferate.…”