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The Discovery of HHV-8
• Kaposi’s sarcoma was one of the original
clinical syndromes that led to the discovery of
HIV
• Thought for many years that the cause was
infectious
• The virus was discovered in 1994 by Yuan
Chang and colleagues at Columbia University
• Belongs to a family of viruses which cause
cancer known as the gammaherpesvirus family
How is HHV-8 Transmitted ?
 Sexual Transmission
 HHV-8 infection has been linked to a history of various
Sexually Transmitted Diseases
 No specific sexual behavior that results in infection has been
identified
 Mother to Child
 In Africa, infections are rare before age two, but the number of
infections in puberty is identical to adult prevalence. This
suggests that children may get HHV-8 from their family
 Transmission through Blood
 Transmission through Saliva
High seroprevalence of antibodies to HHV-8 in
Egyptian children: evidence of non-sexual
transmission
EBV
CMV
100
90
80
70
60
50
40
30
20
10
0
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90
80
70
60
50
40
30
20
10
0
<1
1-3
4-6
7-9
HHV-6
10-12
>12
<1
1-3
4-6
7-9
10-12
>12
HHV-8
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90
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50
40
30
20
10
0
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10
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<1
1-3
4-6
7-9
Years
10-12
>12
<1
1-3
4-6
7-9
Years
10-12
>12
Andreoni. J nat cancer Inst. 1999
The clinical disease that is classically associated with HHV-8 infection is KS
and less commonly Castleman’s disease and primary effusion lymphoma
(PEL). These HHV-8-associated diseases occur most commonly among
immunocompromised patients, such as HIV-infected patients, those with endstage renal disease, and transplant recipients. In the United States, the
incidence of transplant associated KS is 10 to 20 times higher than the general
population
The natural history of human herpesvirus 8 infection: clinical stages and
determinants of progression.
Progression to KS stratified by HHV8 antibody
titers
1.0
0.9
0.8
0.7
Adjusted RH 51.8
0.6
HHV8 antibody
0.5
titers (1:125)
0.4
HHV8 antibody
0.3
titers (1:5 to 1:25)
Adjusted RH 24.8
0.2
0.1
HHV8 negative
0.0
0
1
2
3
4
5
6
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8
9
10
years from seroconversion
Rezza G, Journal of National Cancer Institute, 1999
Manifestazioni cliniche dell’infezione primaria
di HHV8 nell’immunocompromesso
• Febbre, artralgia, linfoadenopatia (iperplasia
angiolinfoide), splenomegalia e citopenia. HIV+
NEJM 1998)
(Oksehendler
• Febbre, splenomegalia, pancitopenia. 2 trapiantati rene
HHV-8 negativi. (Luppi NEJM 2000)
• Multiorgan failure. Bambina di un mese con S. Di George
(Sanchez-Velasco, JID 2001)
• Febbre, sudorazioni, linfoadenopatia, epatite
2000)
(Marcelin AIDS,
• Diarrea, linfoadenopatia rash. 5 omosessuali HIV negativi
(Wang, Blood 2001)
• Esantema maculopapulare e artrite. Donna con artrite
reumatoide (Herpesvirus infections, Parigi 2001)