title: HHV8 a subtype is associated with rapidly evolving classic Kaposi's sarcoma.
abstract: The link between human herpesvirus 8 (KSHV) and Kaposi's sarcoma (KS) has been proven, but many important aspects including risk factors, genetic predisposition to tumor development, transmission of KSHV, and the pathogenic potential of different genotypes remain to be elucidated. Possible associations between clinical parameters and antibody levels, viral load fluctuations, and viral genotype were analyzed by quantitative real-time PCR, an in-house developed IFA assay, and sequence analysis of ORF K1-VR1 in blood, serum and saliva of 38 subjects with classic KS (cKS). KSHV lytic antibodies were significantly increased in stage IV compared to stage I and II patients (p = 0.006 and p = 0.041, respectively). KSHV blood, serum, and saliva viral load was comparable in all stages. The highest viral loads were detected in saliva, and they decreased in stages III-IV compared to stages I-II patients. Higher concentrations of lytic antibodies and higher viral loads were observed in fast progressing cKS patients, in whom KSHV detection from blood was also more frequent. Type A KSHV strain was almost exclusively present in rapid progressors (12/17 cases), while C type was mainly present in slow progressing patients (6/7 cases). Finally, detection of type A KSHV strain associated with higher blood viral loads. KSHV lytic antibody levels and viral load can be used to monitor clinical evolution of cKS. Infection supported by KSHV A subtype is associated with more rapid progressive disease. Careful monitoring and aggressive therapeutic protocols should be considered in patients with KSHV A-supported infection.
authors.affiliation: Laboratory of Molecular Medicine and Biotechnology, Don C Gnocchi Foundation, IRCCS S Maria Nascente, Milan, Italy. rmancuso@dongnocchi.it
authors.forename: Roberta
authors.initials: R
authors.lastname: Mancuso
authors.forename: Renato
authors.initials: R
authors.lastname: Biffi
authors.forename: Marilena
authors.initials: M
authors.lastname: Valli
authors.forename: Monica
authors.initials: M
authors.lastname: Bellinvia
authors.forename: Athanasia
authors.initials: A
authors.lastname: Tourlaki
authors.forename: Tourlaki
authors.initials: T
authors.lastname: Athanasia
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferrucci
authors.forename: Lucia
authors.initials: L
authors.lastname: Brambilla
authors.forename: Serena
authors.initials: S
authors.lastname: Delbue
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ferrante
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.forename: Mario
authors.initials: M
authors.lastname: Clerici
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D001769:Blood / Q000821:virology; D016000:Cluster Analysis; D018450:Disease Progression; D005838:Genotype; D019288:Herpesvirus 8, Human / Q000145:classification* / Q000472:pathogenicity*; D006801:Humans; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods; D012463:Saliva / Q000821:virology; D012514:Sarcoma, Kaposi / Q000821:virology*; D017422:Sequence Analysis, DNA; D044967:Serum / Q000821:virology; D013223:Statistics as Topic; D013997:Time Factors; D019562:Viral Load; D014764:Viral Proteins / Q000235:genetics
chemical_list: D000914:Antibodies, Viral; D014764:Viral Proteins