Detection of herpesvirus-like DNA in the bronchoalveolar lavage fluid of patients with pulmonary Kaposi's sarcoma

Abstract

Pulmonary involvement is a clinically important form of visceral Kaposi's sarcoma in immunocompromised patients. Recently, herpesvirus-like deoxyribonucleic acid (DNA) sequences, defining a new herpesvirus termed "human herpesvirus 8" (HHV8) or "Kaposi's sarcoma-associated herpesvirus" (KSHV), were detected in Kaposi's sarcoma of acquired immune deficiency syndrome (AIDS) and non-AIDS patients. We describe the successful detection of HHV8 DNA in the bronchoalveolar lavage (BAL) fluid of patients with pulmonary Kaposi's sarcoma.Three immunocompromised patients, two HIV seropositive and one after kidney transplantation, suffered from respiratory symptoms and showed pulmonary infiltrates on chest radiography after development of biopsy proven Kaposi's sarcoma of the skin. Bronchoscopy revealed the typical Kaposi like livid endobronchial lesions. BAL fluid was analysed for the presence of HHV8 DNA using a nested polymerase chain reaction (PCR) assay.HHV8 DNA was detected in the BAL fluid of all three patients. In addition, HHV8 DNA could be detected in the skin biopsy tissue, lymph node, and peripheral blood mononuclear cells of these patients.Our data show that human herpesvirus 8 deoxyribonucleic acid can be detected in the bronchoalveolar lavage fluid of patients with pulmonary Kaposi's sarcoma. If further studies reveal a high specificity for human herpesvirus 8 deoxyribonucleic acid detection, this test will improve the tools for the diagnosis of pulmonary Kaposi's sarcoma without further need of biopsies. Eur Respir J., 1996Respir J., , 9, 1743Respir J., -1746

Activation in vivo of retroperitoneal fibromatosis-associated herpesvirus, a simian homologue of human herpesvirus-8.

“…Furthermore, HHV-8 has been detected in the saliva of HIV-1-infected individuals with and without KS (Blackbourn et al, 1998 ;Boldogh et al, 1996 ;Koelle et al, 1997 ;Vieira et al, 1997). We also found RFHVMm in the lungs, which are frequently a site of KS development in AIDS patients, with shedding of HHV-8 detected in pulmonary fluids (Cathomas et al, 1996 ;. In KS patients, HHV-8 is found in all lymphoid organs tested (Corbellino et al, 1996), and we report here that RFHVMm was detected in almost all lymphoid organs.…”

Clinical Features and Contribution of Virological Findings to the Management of Kaposi Sarcoma in Organ-Allograft Recipients

“…In the present study, the results of PCR were always positive for HHV-8 in KS samples and in 1 uninvolved KS lymph node. Although bronchoalveolar lavage fluid has been reported to be useful for HHV-8 detection using PCR in pulmonary KS associated with AIDS 18 and in 1 case of iatrogenic KS, 19 no negative result has been reported previously.…”

The Lung in the Immunocompromised Patient

“…HHV8 is also found in Kaposi’s sarcoma following organ transplantation but not in other transplantation-associated malignomas [49]. HHV8 can be recovered from BAL fluid and shows high specificity and sensitivity for pulmonary involvement of Kaposi’s sarcoma [50, 51, 52]. Recently, HHV8 transmission through transplanted organs has been shown [53].…”