Global Perspectives on Kaposi’s Sarcoma-Associated Herpesvirus Infection

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 3809

Special Issue Editors


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Guest Editor
1. International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa 2. Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
Interests: KSHV; HIV; oncogenic viruses; sub-Saharan Africa

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Guest Editor
International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa
Interests: oncogenic and emerging viruses; KSHV; EBV; HPV; SARS-CoV-2; HIV

Special Issue Information

Dear Colleagues,

Kaposi’s sarcoma-associated herpesvirus (KSHV) presents a peculiar geographical epidemiology primarily burdening sub-Saharan Africa, areas in the Mediterranean, northwestern China and South American Amerindian populations, as well as subpopulations globally, such as men having sex with men (MSM) and persons living with HIV (PLWH). Risk for Kaposi’s sarcoma (KS) development, and other KSHV-related malignancies and syndromes, is highest amongst PLWH who are co-infected with KSHV, which in endemic areas likely takes place during childhood. KSHV, in the context of disease-precipitating factors, one of the most important of which being HIV-related immune suppression, can give rise to KS, multicentric Castleman disease (MCD), primary effusion lymphoma (PEL), and KSHV inflammatory cytokine syndrome (KICS), all of which pose diagnostic and treatment challenges, especially in resource-limited areas.  

This Special Issue, entitled “Global Perspectives on Kaposi's Sarcoma-Associated Herpesvirus Infection”, aims to bring together clinical science, case studies, basic science, and literature reviews addressing advances in our understanding of KSHV epidemiology, infection dynamics and prevention, pathogenesis, presentation of KSHV-related diseases, and treatment strategies. We particularly seek and encourage submissions from globally diverse areas in which KSHV may be highly prevalent but where research profiles may not be well known.

Dr. Melissa Blumenthal
Dr. Georgia Schäfer
Guest Editors

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Keywords

  • KSHV
  • herpesvirus
  • Kaposi’s sarcoma
  • HIV
  • multicentric Castleman disease
  • KICS
  • primary effusion lymphoma
  • AIDS
  • oncogenic virus
  • HAART

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Published Papers (3 papers)

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9 pages, 456 KiB  
Article
Early Changes in Health-Related Quality of Life as a Biomarker of Survival in African Patients with HIV-Associated Kaposi Sarcoma
by Fahmida Shaik, Thomas S. Uldrick, Mikateko Mazinu, Nomonde Gwebushe and Anisa Mosam
Trop. Med. Infect. Dis. 2024, 9(10), 244; https://doi.org/10.3390/tropicalmed9100244 - 17 Oct 2024
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Abstract
Sub-Saharan Africa bears the largest public health burden of Kaposi sarcoma (KS), a leading cause of cancer mortality. Quality of life (QOL) assessments in cancer patients can provide information on prognosis beyond traditional biomarkers or biological measures. The prognostic value of QOL measures [...] Read more.
Sub-Saharan Africa bears the largest public health burden of Kaposi sarcoma (KS), a leading cause of cancer mortality. Quality of life (QOL) assessments in cancer patients can provide information on prognosis beyond traditional biomarkers or biological measures. The prognostic value of QOL measures in patients with HIV-KS was evaluated. Prognostic associations of baseline QOL scores (by quartiles or thresholds for clinical importance) and changes in QOL scores (using minimum important difference) over the first 3 months of therapy were evaluated in 112 participants with HIV-KS randomised to receive ART, with or without chemotherapy. Cox’s regression analysis assessed the prognostic contribution of QOL scores from the EORTC QLQ-C30 questionnaire. Survival curves were generated using the Kaplan–Meier method. Baseline QOL scores did not predict overall survival. The change in the 3-month QOL scores for the global health scale, fatigue, and pain domains was prognostic; the hazard ratios were 3.88 (95% CI 1.32–11.38, p = 0.01), 3.72 (95% CI 1.61–8.62, p = 0.00) and 5.96 (95% CI 2.46–14.43, p = 0.00), respectively. QOL assessments can provide useful prognostic information in patients with HIV-KS. Patients lacking meaningful improvement early into treatment represent a population at high risk of death. Full article
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13 pages, 3250 KiB  
Article
Association between KSHV-Specific Humoral and T Cell Responses with Recurrence of HIV-Associated Kaposi Sarcoma
by Marie-Claire Mukasine, Gina Mulundu, Musonda Kawimbe, Keagan Mutale, Chibamba Mumba, Salum J. Lidenge and Owen Ngalamika
Trop. Med. Infect. Dis. 2024, 9(6), 134; https://doi.org/10.3390/tropicalmed9060134 - 18 Jun 2024
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Abstract
Kaposi sarcoma (KS) is an AIDS-defining angio-proliferative malignancy, with the Kaposi sarcoma-associated herpes virus (KSHV) as its etiologic agent. Upon treatment with chemotherapy, a proportion of HIV-associated KS patients experience disease recurrence within a few months of completing treatment. We aimed at determining [...] Read more.
Kaposi sarcoma (KS) is an AIDS-defining angio-proliferative malignancy, with the Kaposi sarcoma-associated herpes virus (KSHV) as its etiologic agent. Upon treatment with chemotherapy, a proportion of HIV-associated KS patients experience disease recurrence within a few months of completing treatment. We aimed at determining whether KSHV-specific adaptive immune responses were associated with KS recurrence upon complete remission. We conducted a prospective cohort study. The primary outcome was the recurrence of HIV-associated KS. An immunofluorescence assay was used to determine anti-KSHV antibodies, an enzyme-linked immunospot was conducted for T cell responses, PCR was carried out to determine KSHV status, and flow cytometry was used for CD4 counting and immunophenotyping. KSHV detection in PBMCs was high and not associated with KS recurrence-free survival (p = 0.29). Anti-KSHV antibody titers were high and not associated with recurrence-free survival (p = 0.63). KSHV-specific T cell responses dropped from baseline levels among individuals with recurrence, but the drop was not statistically significant. Individuals experiencing KS recurrence had a significantly higher proportion of T cell subsets expressing PD1, while those with sustained remission had a significant increase in CD4 T cell counts from baseline levels during the follow-up period (p = 0.02). Anti-KSHV antibodies are not a good correlate of protection from KS recurrence. T cells in individuals experiencing KS recurrence hadhigh PD1 expression, while an increase in CD4 counts was associated with sustained KS remission. Full article
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13 pages, 5420 KiB  
Case Report
Diagnosis and Management of Kaposi Sarcoma-Associated Herpesvirus Inflammatory Cytokine Syndrome in Resource-Constrained Settings: A Case Report and an Adapted Case Definition
by Tapiwa Kumwenda, Daniel Z. Hodson, Kelvin Rambiki, Ethel Rambiki, Yuri Fedoriw, Christopher Tymchuk, Claudia Wallrauch, Tom Heller and Matthew S. Painschab
Trop. Med. Infect. Dis. 2024, 9(12), 307; https://doi.org/10.3390/tropicalmed9120307 - 16 Dec 2024
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Abstract
Kaposi sarcoma-associated herpes virus (KSHV), also known as human herpes virus 8 (HHV-8), is the primary etiologic cause of Kaposi sarcoma (KS) and KSHV Inflammatory Cytokine Syndrome (KICS). Patients with KICS demonstrate symptoms of systemic inflammation, high KSHV viral load, elevation of inflammatory [...] Read more.
Kaposi sarcoma-associated herpes virus (KSHV), also known as human herpes virus 8 (HHV-8), is the primary etiologic cause of Kaposi sarcoma (KS) and KSHV Inflammatory Cytokine Syndrome (KICS). Patients with KICS demonstrate symptoms of systemic inflammation, high KSHV viral load, elevation of inflammatory markers, and increased mortality. Management requires rapid diagnosis, treatment of underlying HIV, direct treatment of KS, and addressing the hyperimmune response. While a case definition based on clinical presentation, imaging findings, laboratory values, KSHV viral load, and lymph-node biopsy has been proposed, some of the required investigations are frequently unavailable in resource-constrained settings. Due to these challenges, KICS likely remains underdiagnosed and undertreated in these settings. We report a case of a 19-year-old woman living with HIV, and intermittent adherence to her ART, who presented with hypotension and acute hypoxemic respiratory failure. She was found to have high KSHV and HIV viral loads, low CD4 count, anemia, thrombocytopenia, hypoalbuminemia, and elevated inflammatory markers. On bedside ultrasound, she was found to have bilateral pleural effusions, ascites, an enlarged spleen, and hyperechoic splenic lesions. The diagnosis of KICS was made based on this constellation of findings. Weighing the risk and benefits of steroid administration in KS patients, the patient was successfully treated by the continuation of ART and the initiation of paclitaxel chemotherapy and steroids. We propose an adapted case definition relevant to the resource-constrained context. Due to the dual burden of KSHV and HIV in sub-Saharan Africa, additional cases of KICS are likely, and this syndrome will contribute to the burden of early mortality in newly diagnosed HIV patients. Addressing the diagnostic and therapeutic challenges of KICS must be a part of the overall management of the HIV pandemic. Full article
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