Mancuso Roberta, Biffi Renato, Valli Marilena, Bellinvia Monica, Tourlaki Athanasia, Ferrucci Silvia, Brambilla Lucia, Delbue Serena, Ferrante Pasquale, Tinelli Carmine, Clerici Mario
Laboratory of Molecular Medicine and Biotechnology, Don C Gnocchi Foundation, IRCCS S Maria Nascente, Milan, Italy.
J Med Virol. 2008 Dec;80(12):2153-60. doi: 10.1002/jmv.21322.
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.
人类疱疹病毒8型（KSHV）与卡波西肉瘤（KS）之间的联系已得到证实，但许多重要方面，包括风险因素、肿瘤发生的遗传易感性、KSHV的传播以及不同基因型的致病潜力仍有待阐明。通过定量实时PCR、自行开发的免疫荧光分析（IFA）检测以及对38例经典KS（cKS）患者血液、血清和唾液中ORF K1-VR1的序列分析，分析了临床参数与抗体水平、病毒载量波动及病毒基因型之间可能存在的关联。与I期和II期患者相比，IV期患者的KSHV裂解抗体显著增加（分别为p = 0.006和p = 0.041）。所有阶段的KSHV血液、血清和唾液病毒载量相当。唾液中检测到的病毒载量最高，与I-II期患者相比，III-IV期患者的病毒载量有所下降。快速进展的cKS患者中观察到更高浓度的裂解抗体和更高的病毒载量，此类患者血液中KSHV的检测也更频繁。A型KSHV毒株几乎仅存在于快速进展者中（12/17例），而C型主要存在于进展缓慢的患者中（6/7例）。最后，检测到A型KSHV毒株与更高的血液病毒载量相关。KSHV裂解抗体水平和病毒载量可用于监测cKS的临床进展。由KSHV A亚型支持的感染与疾病进展更快相关。对于KSHV A亚型支持感染的患者，应考虑进行密切监测并采取积极的治疗方案。
