Detection and subtyping of human herpesvirus-8 in renal transplant patients before and after remission of Kaposi's sarcoma

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dc.contributor.authorMoosa M.R.
dc.contributor.authorTreurnicht F.K.
dc.contributor.authorVan Rensbubg E.J.
dc.contributor.authorSchneider J.W.
dc.contributor.authorJordaan H.F.
dc.contributor.authorEngelbrecht S.
dc.date.accessioned2011-05-15T16:18:16Z
dc.date.available2011-05-15T16:18:16Z
dc.date.issued1998
dc.description.abstractBackground. Kaposi's sarcoma (KS) is a complication of renal transplantation. If the human herpesvirus-8 (HHV-8) causes KS, the virus should be present in all KS lesions and be drastically reduced or cleared from involved tissue on remission of the KS. Methods. Fourteen renal transplant patients with cutaneous KS, including autopsy material from two cases, were investigated for the presence of HHV-8. A second skin biopsy was taken from 11 survivors, after remission of KS, from normal skin in the same anatomical region as the first biopsy. Remission was induced by reduction or cessation of immunosuppression. A peripheral blood sample was collected simultaneously with the repeat biopsy. A nested polymerase chain reaction assay was used to detect HHV-8 DNA in the biopsy tissue and peripheral blood mononuclear cells followed by direct sequencing of polymerase chain reaction product to detect any nucleotide changes. Results. HHV-8 DNA was detected in all the cutaneous KS and all the visceral KS samples, as well as a number of KS-free organs including the thyroid, salivary gland, and myocardium that have not been described before. Mutations in the viral DNA could be demonstrated in all patients. The mutations found were related more to that seen in AIDS-KS cases than that found in African endemic KS cases. HHV-8 sequences could be detected in follow-up frozen skin biopsies of five patients but were negative in the equivalent formalin-fixed specimens. Viral DNA was also detected in 2 of 11 peripheral blood mononuclear cell samples collected at the time of the follow-up skin biopsies. Conclusion. Reduction or withdrawal of immunosuppression allows the immune system to recover sufficiently to reduce viral replication with subsequent viral persistence and low grade viral replication that coincides with Clinical remission of the KS lesions. This provides further evidence for the important etiological role played by HHV-8 in the pathogenesis of posttransplant KS.
dc.description.versionArticle
dc.identifier.citationTransplantation
dc.identifier.citation66
dc.identifier.citation2
dc.identifier.issn00411337
dc.identifier.other10.1097/00007890-199807270-00013
dc.identifier.urihttp://hdl.handle.net/10019.1/14585
dc.subjectvirus dna
dc.subjectadult
dc.subjectarticle
dc.subjectautopsy
dc.subjectclinical article
dc.subjectfemale
dc.subjectfollow up
dc.subjectgene sequence
dc.subjecthuman
dc.subjecthuman herpesvirus 8
dc.subjectimmunosuppressive treatment
dc.subjectimmunotherapy
dc.subjectindustrialization
dc.subjectkaposi sarcoma
dc.subjectkidney transplantation
dc.subjectmale
dc.subjectnucleotide sequence
dc.subjectpolymerase chain reaction
dc.subjectpriority journal
dc.subjectremission
dc.subjectskin biopsy
dc.subjectsurvival rate
dc.subjectvirus replication
dc.subjectAdult
dc.subjectDNA, Viral
dc.subjectFemale
dc.subjectHerpesvirus 8, Human
dc.subjectHumans
dc.subjectKidney Transplantation
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectSarcoma, Kaposi
dc.titleDetection and subtyping of human herpesvirus-8 in renal transplant patients before and after remission of Kaposi's sarcoma
dc.typeArticle
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