Aged ; Female ; Herpesvirus 8, Human ; isolation & purification ; Humans ; Immunosuppressive Agents ; adverse effects ; Pemphigoid, Bullous ; complications ; Sarcoma, Kaposi ; virology

BACKGROUNDThe infection of Kaposi's sarcoma-associated herpes virus (KSHV) is most likely the cause of clinical Kaposi's sarcoma, primary effusion lymphoma, and multi-center Castleman's disease. KSHV infection has very limited epidemiological survey data in China, and its definite mode of transmission remains controversial. This study aimed to determine the infection status and the main transmission route of KSHV in Chinese population.

METHODSAn enzyme-linked immunosorbent assay (ELISA) utilizing KSHV ORF65 recombinant protein was employed to analyze the antibody response to KSHV ORF65 in sera from 122 healthy physical examination people, 107 intravenous drug users, 135 non-intravenous drug users, 211 hepatitis B (HBV) patients infected via blood transmission, 107 kidney transplant recipients, and 72 female sex workers in Zhejiang Province in Southeast China.

RESULTSKSHV infection occurred relatively common (13.1%) in healthy population in Zhejiang, China. Infection rate was 16.7% in female sex workers, but significantly elevated in intravenous drug addicts (58.9%), blood-transmitted HBV patients (28.0%) and kidney transplant patients (41.1%).

CONCLUSIONBlood borne transmission of KSHV is probably the main route of infection in Zhejiang Province.

Enzyme-Linked Immunosorbent Assay ; Herpesviridae Infections ; epidemiology ; transmission ; Herpesvirus 8, Human ; genetics ; isolation & purification ; pathogenicity ; Humans ; Open Reading Frames ; genetics

OBJECTIVETo study the relationship between Kaposi's sarcoma (KS) and human herpes virus 8 (HHV8; Kaposi's sarcoma-associated herpes virus), and to develop an in situ hybridization (ISH) technique effective for clinical pathological diagnosis.

METHODSPolymerase chain reaction (PCR) technique was used to synthesize a digoxigenin-labeled single stranded DNA probe specific for HHV8 open reading frame 72 cyclin D homolog gene encoded mRNA as the probe accompanying with a tyramide signal amplification system (TSA) for ISH assay. Totally 20 formalin-fixed and paraffin-embedded samples from 14 cases of KS from Danish patients were collected for HHV8 detection. In order to compare the result obtained, all of these cases were checked simultaneously using PCR technique.

RESULTSHHV8 was detected in 10 of 14 (71%) KS cases, of which 8 cases were positive for HHV8 by both ISH and PCR. In ISH, HHV8 hybridization signal was seen as a dot or patch located in the nuclei of both the neoplastic spindle cells and the endothelial cells. HHV8 was found in lesions in all the stages of KS including early patch, plaque and late nodular or tumor lesions, as well as in the primary and metastatic lesions. All the control cases showed a relevant positive or negative results.

CONCLUSIONSThe results further confirmed that there is a strong association between Kaposi's sarcoma and HHV8. The ISH technique with single stranded probe and TSA would be helpful in clinical pathological diagnosis for HHV8 infected diseases, such as KS, primary effusion lymphoma and multicentric Castleman's disease.

Adolescent ; Adult ; Female ; Herpesvirus 8, Human ; isolation & purification ; Humans ; In Situ Hybridization ; methods ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Sarcoma, Kaposi ; pathology ; virology ; Tyramine

OBJECTIVETo research the co-infections of HIV and human herpesvirus 8 (HHV8) in Uygur high-risk groups of HIV infection in a city Xinjiang.

METHODSAll 468 Uygurs at high HIV risk registered in the sentinel monitoring system in 2006 were enrolled in this study. The antibodies to HHV8 latency-associated nuclear antigens 1 (LANA1), lytic antigens open reading frame 65 (ORF65) and K8.1 were measured by enzyme linked immunosorbent assay (ELISA). Chi-square test and non-condition Logistic regression model were used for data analysis.

RESULTSOf 468 sera samples, 67 (14.3%) were HIV and HHV8 co-infection positive.Male's HIV and HHV8 co-infection rate (22.6%, 54/239) was higher than the female's (5.7%, 13/229) (chi(2) = 27.285, P < 0.001). For those above 24 year old, HIV and HHV8 co-infection rate (15.8%, 65/412) was higher than the < 24 year old group's (3.6%, 2/56) (chi(2) = 5.987, P = 0.014). The group of Elementary school and illiterate people's HIV and HHV8 co-infection rate (20.7%, 40/193) was higher than the junior middle school and the above culture (9.8%, 27/275) (chi(2) = 10.999, P = 0.001). For the unmarried people, the co-infecting rate of HIV and HHV8 for the married, the cohabitants, the divorced or the widowers were 16.9% (14/83), 12.2% (42/345), 27.5% (11/40) respectively. There was significantly statistical difference among three marital status (chi(2) = 7.399, P = 0.025). Injecting drug users' HIV and HHV8 co-infection rate (26.5%, 50/189) was higher than non-injecting drug users' (6.1%, 17/279) (chi(2) = 38.083, P < 0.001), and stratified by gender, OR(M-H) was 4.207 (95%CI: 1.529 - 11.578). Via non-condition logistic stepwise regression analysis, only injecting drug use entered model, compared with non-injecting drug users, injecting drug users were more dangerous for HIV and HHV8 co-infecting (OR = 5.544; 95%CI: 3.081 - 9.975).

CONCLUSIONThe HIV and HHV8 co-infection rate was higher in the Uygurs at high HIV risk in Xinjiang. Injecting drug use is a risk factor of the HIV and HHV8 co-infection, which might be one of routes of HIV and HHV8 co-infection among this group.

Adolescent ; Adult ; Aged ; Child ; China ; epidemiology ; Female ; HIV Infections ; epidemiology ; ethnology ; virology ; Herpesviridae Infections ; epidemiology ; Herpesvirus 8, Human ; isolation & purification ; Humans ; Male ; Middle Aged ; Population Surveillance ; Young Adult

Kaposi sarcoma herpes virus (KSHV), also known as human herpesvirus-8, plays an important role in the pathogenesis of Kaposi sarcoma (KS), multicentric Castleman disease (MCD) of the plasma cell type, and primary effusion lymphoma. KSHV is rarely associated with the hemophagocytic syndrome (HPS), but when it does occur, it most occurs in immunocompromised patients. We report herein an unusual case of KSHV-associated HPS in an immunocompetent patient. A previously healthy 62-yr-old male was referred for evaluation of leukocytopenia and multiple lymphadenopathies. After a lymph node biopsy, he was diagnosed with MCD of the plasma cell type. KSHV DNA was detected in the lymph node tissue by polymerase chain reaction. Following a short-term response of the leukocytopenia to prednisolone, mental change, left side weakness, fever, thrombocytopenia, hemolytic anemia, and renal failure developed. Despite intravenous immunoglobulin therapy and plasmapheresis, he expired. The lymph nodes were infiltrated by hemophagocytic histiocytes in the sinuses. Pulmonary nodules and gastric erosions were shown to be KS. KSHV DNA was detected in the stomach, lung, and liver. This is the first case of multiple KSHV associated diseases including MCD and KS with KSHV-associated hemophagocytic syndrome in an HIV-negative, non-transplant, immunocompetent patient.
Autopsy ; Giant Lymph Node Hyperplasia/complications/*diagnosis/pathology ; HIV Seronegativity ; Herpesviridae Infections/*diagnosis ; Herpesvirus 8, Human/*isolation & purification ; Humans ; Immunocompetence ; Lymphohistiocytosis, Hemophagocytic/*diagnosis/etiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Polymerase Chain Reaction ; Sarcoma, Kaposi/complications/*diagnosis

Antiviral Agents ; therapeutic use ; Castleman Disease ; drug therapy ; metabolism ; pathology ; virology ; Dendritic Cells, Follicular ; pathology ; Herpesviridae Infections ; virology ; Herpesvirus 8, Human ; isolation & purification ; Humans ; Interleukin-6 ; blood ; Receptor, Epidermal Growth Factor ; metabolism

OBJECTIVESTo study the clinicopathologic features of Rosai-Dorfman disease (RDD), expression of various antigens, human herpes virus type 8 (HHV8), human papillomavirus (HPV)-DNA and Epstein-Barr virus (EBV)-mRNA, and compare the findings with those in the literature.

METHODSThe clinicopathologic findings of 16 Rosai-Dorfman disease cases were retrospectively reviewed. Immunohistochemical study for S-100 protein, CD68 (PG-M1), CD163, CD21, CD1a, CD20, CD45RO, CD4, CD8, M-CSF and HHV8 was carried out in 9 of the 16 cases. In-situ hybridization for EBV-mRNA and HPV-DNA was also performed.

RESULTSThe male-to-female ratio of the patients was 4.33:1. Amongst the 16 cases studied, 62.5% (10/16) presented nodal RDD, with cervical lymph node predominantly involved. Half of these cases had affected lymph nodes in more than one anatomic site. Extranodal RDD represented 37.5% (6/16) of the cases. The relapse rate of extranodal RDD was higher than that of nodal RDD. Histologically, nodal RDD was characterized by dilated sinuses filled with large polygonal histiocytes which contained lymphocytes and plasma cells. For extranodal lesions, various degrees of stromal fibrosis were seen in association with mixed inflammatory cells (especially plasma cells). The large polygonal histiocytes varied in number and were distributed in clusters or patches. Immunohistochemical study showed that the abnormal histiocytes were strongly positive for S-100 protein. They also expressed CD68, CD163 and M-CSF, but were negative for CD1a, CD21 and HHV8. The lymphocytes in cytoplasm of these histiocytes were positive for both T and B cell markers (with T cell predominance, including a mixture of CD4- and CD8-positive cells). HPV-DNA and EBV-mRNA were not detected by in-situ hybridization. To date, 62 cases of RDD have been reported in mainland China, including 34 cases of nodal RDD and 18 cases of extranodal RDD. The remaining 10 cases involved both lymph nodes and extranodal sites. Compared with overseas reports, RDD occurring in China tended to affect older patients and with slight male predilection.

CONCLUSIONSRosai-Dorfman disease is relatively rare in China. Pathologic diagnosis of extranodal RDD may be difficult. The demographic data of RDD in China, including age and sex of patients, are different from those in the literature.

Adolescent ; Adult ; Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Bone Diseases ; metabolism ; pathology ; virology ; Child ; DNA, Viral ; analysis ; Female ; Follow-Up Studies ; Herpesvirus 8, Human ; genetics ; isolation & purification ; Histiocytosis, Sinus ; metabolism ; pathology ; virology ; Humans ; Immunohistochemistry ; Lymph Nodes ; pathology ; Macrophage Colony-Stimulating Factor ; metabolism ; Male ; Middle Aged ; Nose Diseases ; metabolism ; pathology ; virology ; RNA, Viral ; analysis ; Receptors, Cell Surface ; metabolism ; Retrospective Studies ; S100 Proteins ; metabolism ; Skin Diseases ; metabolism ; pathology ; virology ; Young Adult