Serological and immunohistochemical detection of human herpesvirus 8 in Kaposi's sarcoma after immunosuppressive therapy for bullous pemphigoid.

Abstract

Kaposi's sarcoma (KS) developed in an 87-year-old human immunodeficiency virus-negative woman from Hokkaido island 4 months after oral administration of prednisolone for the treatment of bullous pemphigoid (BP), and rapidly disseminated to almost the entire body within 2 months. The open reading frame (ORF) 59 and ORF73 proteins encoded by human herpesvirus 8 (HHV-8) were detected immunohistochemically in the nuclei of the tumour cells of KS. The protein coded by ORF73, latent protein, was detected in most of the nuclei of the tumour cells, but only a few tumour nuclei were positive for the ORF59 protein, a lytic protein expressed during active infection. The antibodies against both lytic and latent proteins of HHV-8 were detected retrospectively in the serum 4 months before the appearance of KS and before prednisolone therapy had been started. Immunosuppression associated with the treatment for BP possibly activated latent HHV-8 infection and induced the development of KS.

Higher prevalence of human herpesvirus 8 DNA sequence and specific IgG antibodies in patients with pemphigus in China

“…It is possible that immunosuppressive therapy for autoimmune diseases allows an opportunistic infection or reactivation of HHV-8 as observed in bullous pemphigoid. [51][52][53] However, HHV-8 DNA sequence was detected in lesional skin from patients with PF and PV who had not received any immnuosuppressive therapy. 36 In our study, 14 of 21 patients who were positive for HHV-8 DNA sequence and/or specific IgG antibodies had not received any systemic immnuosuppressive therapy before the collection of the specimens, suggesting that HHV-8 infection induced by the therapy is unlikely.…”

Autoimmune bullous diseases in non‐HIVKaposi's sarcoma: a retrospective study in a large cohort of patients

“…In this group, the most common intervention for KS was the corticosteroid dosage reduction, consequently with complete or almost complete remission in 12 of 18 cases. On the other hand, two patients receiving prednisone at a dose 30–40 mg/day died briefly after KS onset …”

Human herpesvirus 8 – A novel human pathogen

“…The protein has been localized to the nuclear membrane via IFA and is observed in approximately 30% of induced PEL cells, but in less than 8% of uninduced cells [224]. The Orf 59 gene product, processivity factor-8, has been shown to be present in AIDS-KS tumors (50%) although perhaps not in as many spindle cells as Orf 73 [225]. Approximately 30% of AIDS-KS patients had antibodies against this antigen [226].…”

“…Approximately 30% of AIDS-KS patients had antibodies against this antigen [226]. Orf 59 might be helpful in identifying aggressive KS disease [225,226]. …”