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移植相关的 HHV-8 相关疾病:聚焦诊断和预防的病例报告和叙述性综述。

HHV-8-associated diseases in transplantation: A case report and narrative review focused on diagnosis and prevention.

机构信息

Transplant and Oncology Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Transplant Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Transpl Infect Dis. 2024 Nov;26 Suppl 1:e14334. doi: 10.1111/tid.14334. Epub 2024 Jul 7.

Abstract

BACKGROUND

Human herpes virus 8 (HHV-8) or Kaposi sarcoma herpesvirus (KSHV) is an opportunistic oncovirus that causes multiple pathologic entities.

METHODS

We present a case of fatal HHV-8-associated multisystem illness with disseminated Kaposi sarcoma and HHV8-associated lymphoproliferative disorder with systemic inflammation. We conducted a narrative review of the literature on HHV-8 in transplantation with a goal of illuminating the spectrum of HHV-8-associated diseases in this vulnerable population, modes of disease transmission, and the potential role for donor and recipient screening.

RESULTS

HHV-8-associated KS, primary effusion lymphoma (PEL), multicentric Castleman disease (MCD), and KSHV inflammatory cytokine disorder (KICS) may affect transplant recipients; with the exception of KS, these conditions are rare but carry high morbidity and mortality.

CONCLUSION

HHV-8-associated diseases have diverse and protean manifestations in transplant recipients, with potentially fatal outcomes. HHV-8 seroprevalence among organ donors and the magnitude of risk for donor-derived HHV-8 infection or clinically significant disease remain unknown and require further study.

摘要

背景

人类疱疹病毒 8 型(HHV-8)或卡波济肉瘤相关疱疹病毒(KSHV)是一种机会性致癌病毒,可引起多种病理实体。

方法

我们报告了一例致命的 HHV-8 相关多系统疾病,伴有弥漫性卡波济肉瘤和 HHV8 相关淋巴增生性疾病伴全身炎症。我们对移植中的 HHV-8 进行了文献综述,旨在阐明该脆弱人群中 HHV-8 相关疾病的范围、疾病传播模式以及供体和受体筛查的潜在作用。

结果

HHV-8 相关的卡波济肉瘤、原发性渗出性淋巴瘤(PEL)、多中心 Castleman 病(MCD)和 KSHV 炎症细胞因子紊乱(KICS)可能影响移植受者;除了卡波济肉瘤,这些疾病很少见,但发病率和死亡率很高。

结论

HHV-8 相关疾病在移植受者中有多种表现形式,且可能导致致命后果。器官供体中 HHV-8 的血清阳性率以及供体源性 HHV-8 感染或有临床意义的疾病的风险程度尚不清楚,需要进一步研究。

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