Kaposi sarcoma-associated herpesvirus

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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