Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Kenya Medical Research Institute/Center for Global Health Research, Kisumu, Kenya.
J Infect Dis. 2020 Jun 16;222(1):111-120. doi: 10.1093/infdis/jiaa060.
Endemic Burkitt lymphoma (eBL) is associated with Epstein-Barr virus (EBV) and Plasmodium falciparum malaria coinfections. However, the role of Kaposi sarcoma-associated herpesvirus (KSHV), also endemic in Africa, has not been evaluated as a cofactor in eBL pathogenesis.
Multiplexed seroprofiles for EBV, malaria, and KSHV were generated for 266 eBL patients, 78 non-eBL cancers, and 202 healthy children. KSHV and EBV loads were quantified by PCR.
KSHV seroprevalence did not differ by study group but was associated with age. Seropositivity, defined by K8.1/LANA or in combination with 5 other KSHV antigens (ORF59, ORF65, ORF61, ORF38, and K5) was associated with antimalarial antibody levels to AMA1 (odds ratio [OR], 2.41, P < .001; OR, 2.07, P < .001) and MSP1 (OR, 2.41, P = .0006; OR, 5.78, P < .001), respectively. KSHV loads did not correlate with antibody levels nor differ across groups but were significantly lower in children with detectable EBV viremia (P = .014).
Although KSHV-EBV dual infection does not increase eBL risk, EBV appears to suppress reactivation of KSHV while malaria exposure is associated with KSHV infection and/or reactivation. Both EBV and malaria should, therefore, be considered as potential effect modifiers for KSHV-associated cancers in sub-Saharan Africa.
地方性伯基特淋巴瘤（eBL）与 EBV 和恶性疟原虫疟疾的合并感染有关。然而，在非洲流行的卡波西肉瘤相关疱疹病毒（KSHV）是否作为 eBL 发病机制的协同因素尚未得到评估。
对 266 例 eBL 患者、78 例非 eBL 癌症患者和 202 例健康儿童进行了 EBV、疟疾和 KSHV 的多重血清学检测。通过 PCR 定量了 KSHV 和 EBV 的载量。
KSHV 的血清流行率在研究组之间没有差异，但与年龄有关。K8.1/LANA 或与其他 5 种 KSHV 抗原（ORF59、ORF65、ORF61、ORF38 和 K5）联合定义的 KSHV 血清阳性与 AMA1（比值比 [OR]，2.41，P<0.001；OR，2.07，P<0.001）和 MSP1（OR，2.41，P=0.0006；OR，5.78，P<0.001）的抗疟抗体水平相关。KSHV 载量与抗体水平无关，各组之间也没有差异，但在可检测到 EBV 病毒血症的儿童中明显较低（P=0.014）。
尽管 KSHV-EBV 双重感染不会增加 eBL 的风险，但 EBV 似乎抑制了 KSHV 的再激活，而疟疾暴露与 KSHV 感染和/或再激活相关。因此，EBV 和疟疾都应被视为撒哈拉以南非洲 KSHV 相关癌症的潜在效应修饰因子。
