Background
- One of the human herpesviruses (family Herpesviridae, subfamily Gammaherpesvirinae)
- Seroprevalence varies by geography and group
- US general population 1-5%
- US men who have sex with men 15-20%
- US MSM with HIV 30-35%
- Some Mediterranean countries 10-20%
- Sub-Saharan African countries 30-80%
- Possibly transmitted through saliva or sex
Clinical Manifestations
- Mostly asymptomatic
- Primary infection consists of fever, rash, lymphadenopathy, and bone marrow failure, and may rapidly progress to Kaposi sarcoma
- Kaposi sarcoma (KS)
- Hyperpigmented macules or nodules
- Mostly skin but can include mouth, respiratory tract, and GI tract as well
- Primary effusion lymphoma (PEL)
- Causes effusions isolated to the pleural, pericardial, or abdominal cavities
- Occasionally causes mass lesions and extracavitary disease within skin, hematopoietic organs, and the GI tract
- Multicentric Castleman disease (MCD)
- Causes systemic symptoms including fever and night sweats, generalized adenopathy, fever, and hepatosplenomegaly
- Kaposi sarcoma-associated herpesvirus inflammatory cytokine syndrome (KICS)
- Like MCD but without pathology demonstrating MCD
- Patients are often critically ill
Management
- For Kaposi sarcoma with symptomatic visceral involvement, chemotherapy is recommended
- May be indicated for disseminated cutaneous KS as well
Further Reading
