Mohanna Salim, Maco Vicente, Bravo Francisco, Gotuzzo Eduardo
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
Int J Infect Dis. 2005 Sep;9(5):239-50. doi: 10.1016/j.ijid.2005.02.004.
To review the current South American literature on classic Kaposi's sarcoma (KS) and human herpesvirus 8 (HHV-8), and point the way for studies that still need to be performed.
The authors performed an exhaustive search in LILACS, SCIELO and PUBMED databases for classic KS and HHV-8 in South America. The relevant material was evaluated and reviewed.
More than 250 cases have been reported with three big case series (Argentina, Colombia and Peru). The classic KS form seen in Colombia resembles the type of disease seen among African communities; the same unusual presentation with confluent exophytic nodules or eroded lesions has been noticed in Peru. Low rates of HHV-8 antibodies have been found in blood donors from Chile, Argentina and Brazil (3%, 4%, 2.8-7.4%, respectively); whereas high rates of HHV-8 antibodies have been found in Amerindians from Brazil and Ecuador. Five specimens from Argentina were subtyped: (three classic KS and two AIDS KS); the identified strains fell into subtypes A and C. AIDS-related KS specimens from Brazil and Venezuela were subtyped: (43 and nine respectively); analysis grouped them predominantly into subgroups A, B and C. A new HHV-8 subtype E was found endemic in Brazilian and Ecuadorian Amerindians. In French Guiana ten endemic KS and six AIDS-related KS specimens were subtyped; analysis grouped them predominantly into subgroups A, B and C.
Classic KS in South America has a very similar clinical presentation but not the same as the classic KS variety described in the Mediterranean. Initial seroprevalence studies performed in the general population and in blood donors showed low seroprevalence of HHV-8, whereas high seroprevalence rates were seen in Amerindian population. The existing serological assays, nonetheless, need to be further refined, and new assays need to be developed. Finally, the key to understanding the precise molecular epidemiology and phylogenetic distribution of HHV-8 in South America would be to perform more subtyping of classic KS cases.
回顾当前南美洲关于经典型卡波西肉瘤（KS）和人类疱疹病毒8型（HHV - 8）的文献，并为仍需开展的研究指明方向。
作者在LILACS、SCIELO和PUBMED数据库中对南美洲的经典型KS和HHV - 8进行了详尽检索。对相关资料进行了评估和综述。
已报道了250多例病例，有三个大型病例系列（阿根廷、哥伦比亚和秘鲁）。在哥伦比亚所见的经典型KS形式类似于在非洲社区中见到的疾病类型；在秘鲁也注意到了相同的不寻常表现，即融合性外生性结节或糜烂性病变。在智利、阿根廷和巴西的献血者中发现HHV - 8抗体率较低（分别为3%、4%、2.8 - 7.4%）；而在巴西和厄瓜多尔的美洲印第安人中发现HHV - 8抗体率较高。对来自阿根廷的5个标本进行了亚型分析：（3个经典型KS和2个艾滋病相关KS）；鉴定出的毒株属于A和C亚型。对来自巴西和委内瑞拉的艾滋病相关KS标本进行了亚型分析：（分别为43个和9个）；分析主要将它们归为A、B和C亚组。发现一种新的HHV - 8 E亚型在巴西和厄瓜多尔的美洲印第安人中呈地方性流行。在法属圭亚那，对10例地方性KS和6例艾滋病相关KS标本进行了亚型分析；分析主要将它们归为A、B和C亚组。
南美洲的经典型KS有非常相似的临床表现，但与地中海地区描述的经典型KS不同。在普通人群和献血者中进行的初步血清流行率研究显示HHV - 8血清流行率较低，而在美洲印第安人群中则较高。然而，现有的血清学检测方法需要进一步完善，并且需要开发新的检测方法。最后，了解HHV - 8在南美洲的确切分子流行病学和系统发育分布的关键在于对更多经典型KS病例进行亚型分析。
