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Lurain KA, Ramaswami R, Krug LT, Whitby D, Ziegelbauer JM, Wang HW, Yarchoan R. HIV-associated cancers and lymphoproliferative disorders caused by Kaposi sarcoma herpesvirus and Epstein-Barr virus. Clin Microbiol Rev 2024; 37:e0002223. [PMID: 38899877 PMCID: PMC11391709 DOI: 10.1128/cmr.00022-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
SUMMARYWithin weeks of the first report of acquired immunodeficiency syndrome (AIDS) in 1981, it was observed that these patients often had Kaposi sarcoma (KS), a hitherto rarely seen skin tumor in the USA. It soon became apparent that AIDS was also associated with an increased incidence of high-grade lymphomas caused by Epstein-Barr virus (EBV). The association of AIDS with KS remained a mystery for more than a decade until Kaposi sarcoma-associated herpesvirus (KSHV) was discovered and found to be the cause of KS. KSHV was subsequently found to cause several other diseases associated with AIDS and human immunodeficiency virus (HIV) infection. People living with HIV/AIDS continue to have an increased incidence of certain cancers, and many of these cancers are caused by EBV and/or KSHV. In this review, we discuss the epidemiology, virology, pathogenesis, clinical manifestations, and treatment of cancers caused by EBV and KSHV in persons living with HIV.
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Affiliation(s)
- Kathryn A Lurain
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Ramya Ramaswami
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Laurie T Krug
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Joseph M Ziegelbauer
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Hao-Wei Wang
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert Yarchoan
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
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Sabourin KR, Marshall VA, Eaton W, Kimono B, Mugisha J, Miley WJ, Labo N, Samayoa-Reyes G, Whitby D, Rochford R, Newton R. Factors affecting Kaposi's sarcoma-associated herpesvirus transmission in rural Ugandan households, a longitudinal study. RESEARCH SQUARE 2024:rs.3.rs-4855275. [PMID: 39315255 PMCID: PMC11419167 DOI: 10.21203/rs.3.rs-4855275/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Background We report the impact of HIV infection within a household on oral Kaposi's sarcoma-associated herpesvirus (KSHV) shedding. Methods We enrolled 469 individuals from 90 households. Mouthwash rinse samples collected at three monthly visits, were analyzed for KSHV DNA using quantitative polymerase chain reaction (qPCR). Generalized linear mixed effects logistic models were applied to analyze factors associated with KSHV ever shedding, and among shedders, always versus intermittent shedding. Linear mixed effects models were applied to models of KSHV viral loads. Intraclass correlation coefficients (ICCs) were calculated to assess the contribution of household-level factors to variations in shedding probabilities. Hotspot analyses of geospatial feature clusters were calculated using Getis-Ord Gi* statistic and visualized using inverse distance weighted interpolation. Results Analyses included 340 KSHV seropositive individuals, aged 3 + years, with qPCR results from 89 households. Forty households had 1 + persons living with HIV (PLWH), while 49 had none. Among participants, 149(44%) were KSHV ever shedders. Of 140 who shed KSHV at two or more visits, 34(24%) were always shedders. Increasing number of KSHV seropositive household members was significantly associated with ever shedding [Odds ratio(OR) (95% Confidence Interval(95%CI)):1.14(1.03,1.26);p = 0.013]. Among KSHV shedders, a statistically significant age-related trend was identified with 10-19 years being more likely to be always shedders (type III test p = 0.039) and to have higher viral loads (type III test p = 0.027). In addition, higher viral loads were significantly associated with increasing number of household members [coefficient(95%CI):0.06(0.01,0.12);p = 0.042], increasing number of KSHV seropositive members [coefficient(95%CI):0.08(0.01,0.15);p = 0.021], and living in households with 1 + PLWH [coefficient(95%CI):0.51(0.04,0.98);p = 0.033]. Always shedders exhibited higher viral loads than intermittent shedders [coefficient(95%CI):1.62(1.19,2.05);p < 0.001], and viral loads increased with the number of visits where KSHV DNA was detected in saliva (type III test p < 0.001). Household-level factors attributed for 19% of the variability in KSHV shedding (ICC:0.191;p = 0.010). Geospatial analysis indicated overlapping hotspots of households with more KSHV seropositive individuals and KSHV shedders, distinct from areas where PLWH were clustered. Discussion KSHV oral shedding is influenced by multiple factors at the individual, household, and regional levels. To mitigate ongoing KSHV transmission a comprehensive understanding of factors contributing to oral KSHV reactivation and transmission within households is needed.
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Nalwoga A, Sabourin KR, Miley W, Jackson C, Maktabi M, Labo N, Mugisha J, Whitby D, Rochford R, Newton R. Plasmodium falciparum Malaria Is Associated With Increased Kaposi Sarcoma-Associated Herpesvirus (KSHV) Seropositivity and Higher KSHV Antibody Breadth and Magnitude: Results of a Case-Control Study From Rural Uganda. J Infect Dis 2024; 229:432-442. [PMID: 37536670 PMCID: PMC10873168 DOI: 10.1093/infdis/jiad308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/12/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Previously, we showed that children with asymptomatic Plasmodium falciparum (Pf) malaria infection had higher Kaposi sarcoma-associated herpesvirus (KSHV) viral load, increased risk of KSHV seropositivity, and higher KSHV antibody levels. We hypothesize that clinical malaria has an even larger association with KSHV seropositivity. In the current study, we investigated the association between clinical malaria and KSHV seropositivity and antibody levels. METHODS Between December 2020 and March 2022, sick children (aged 5-10 years) presenting at a clinic in Uganda were enrolled in a case-control study. Pf was detected using malaria rapid diagnostic tests (RDTs) and subsequently with quantitative real-time polymerase chain reaction (qPCR). Children with malaria were categorized into 2 groups: RDT+/PfPCR+ and RDT-/PfPCR+. RESULTS The seropositivity of KSHV was 60% (47/78) among Pf-uninfected children, 79% (61/77) among children who were RDT-/PfPCR+ (odds ratio [OR], 2.41 [95% confidence interval {CI}, 1.15-5.02]), and 95% (141/149) in children who were RDT+/PfPCR+ (OR, 10.52 [95% CI, 4.17-26.58]; Ptrend < .001). Furthermore, RDT+/PfPCR+ children followed by RDT-/PfPCR+ children had higher KSHV IgG and IgM antibody levels and reacted to more KSHV antigens compared to uninfected children. CONCLUSIONS Clinical malaria is associated with both increased KSHV seropositivity and antibody magnitude, suggesting that Pf is affecting KSHV immunity.
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Affiliation(s)
- Angela Nalwoga
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
- Cancer Epidemiology Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Katherine R Sabourin
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Conner Jackson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado
| | - Mahdi Maktabi
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Joseph Mugisha
- Cancer Epidemiology Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Robert Newton
- Cancer Epidemiology Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Health Sciences, University of York, York, United Kingdom
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Tibenderana RM, Blumenthal MJ, Bukajumbe E, Schäfer G, Mohamed Z. Clinical Significance of Elevated KSHV Viral Load in HIV-Related Kaposi's Sarcoma Patients in South Africa. Viruses 2024; 16:189. [PMID: 38399965 PMCID: PMC10893554 DOI: 10.3390/v16020189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Kaposi's sarcoma (KS) is an AIDS-defining illness caused by Kaposi's sarcoma-associated herpesvirus (KSHV) predominantly in the context of HIV-related immune suppression. We aimed to explore the usefulness of KSHV DNA viral load (VL) measurement in predicting the severity, response to treatment and outcome of KS. We retrospectively assessed a cohort of KS patients (n = 94) receiving treatment at Groote Schuur Hospital, Cape Town, South Africa. Demographic and clinical data, KS staging and response to treatment were extracted from patient files, while long-term survival was ascertained from hospital records. KSHV serology and VL and hIL-6 were determined empirically from patients' blood. All patients were HIV-positive adults, the majority of whom were on HAART at the time of recruitment. KSHV VL was detectable in 65 patients' blood (median: 280.5/106 cells (IQR: 69.7-1727.3)) and was highest in patients with S1 HIV-related systemic disease (median 1066.9/106 cells, IQR: 70.5-11,269.6). KSHV VL was associated with the S1 stage in a binomial regression controlling for confounders (adjusted odds ratio 5.55, 95% CI: 1.28-24.14, p = 0.022). A subset of six patients identified to have extremely high KSHV VLs was predominantly T1 stage with pulmonary KS, and most had died at follow-up. In our cohort, elevated KSHV VL is associated with systemic HIV-related illness in KS disease. Extremely high KSHV VLs warrant further investigation for patients potentially requiring intensive treatment and investigation for progression or diagnosis of concurrent KSHV lytic syndromes.
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Affiliation(s)
| | - Melissa Jayne Blumenthal
- Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa;
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa
| | - Emmanuel Bukajumbe
- Aberdeen Surgery, Aberdeen, NSW 2336, Australia;
- Hatchile Consult Ltd., Kampala 759125, Uganda
| | - Georgia Schäfer
- Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa;
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa
| | - Zainab Mohamed
- Department of Radiation Oncology, University of Cape Town, Cape Town 7925, South Africa;
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Sabourin KR, Ogolla S, Reyes GS, Daud I, Jackson CL, Labo N, Miley W, Whitby D, Lamb MM, Rochford R, Dent A. Effects of Maternal HIV Infection on Early Kaposi Sarcoma-Associated Herpesvirus Seroconversion in a Kenyan Mother-Infant Cohort. J Infect Dis 2023; 228:1357-1366. [PMID: 37536370 PMCID: PMC10640772 DOI: 10.1093/infdis/jiad310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/06/2023] [Accepted: 08/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND We identified whether maternal human immunodeficiency virus (HIV) infection during pregnancy affects transplacental transfer of Kaposi sarcoma-associated herpesvirus (KSHV)-specific antibodies and subsequent infant infection. METHODS We followed pregnant Kenyan women through delivery and their infants until age 2 years. Children were classified as HIV-exposed uninfected (HEU) or HIV-unexposed uninfected (HUU) based on maternal HIV status. Maternal venous and cord blood at delivery and child venous blood every 6 months were tested for antibodies to 20 KSHV antigens by multiplex bead-based immunoassay. Multiple comparisons were adjusted using false discovery rate (FDR). RESULTS Maternal HIV infection was significantly associated with decreased transplacental transfer of antibodies against all KSHV antigens and lower cord blood levels for 8 antigens at FDR P < .10. Neither birth to 6-month antibody level changes nor 6-month levels differed in HEU and HUU, except for ORF50. By age 24 months, 74% of children KSHV seroconverted but HEU and HUU did not differ in time to seroconversion nor 2-year seropositivity after adjustment for child malaria infection. CONCLUSIONS Maternal HIV infection reduced a child's initial KSHV antibody levels but did not affect age of infection. Regardless of HIV exposure in utero, KSHV seroconversion in Kenyan children occurred early; associated factors must be identified.
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Affiliation(s)
- Katherine R Sabourin
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sidney Ogolla
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Gabriela Samayoa Reyes
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ibrahim Daud
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Conner L Jackson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Nazzarena Labo
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Wendell Miley
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Denise Whitby
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Molly M Lamb
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Center for Global Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Arlene Dent
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
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Fu L, Tian T, Wang B, Lu Z, Gao Y, Sun Y, Lin YF, Zhang W, Li Y, Zou H. Global patterns and trends in Kaposi sarcoma incidence: a population-based study. Lancet Glob Health 2023; 11:e1566-e1575. [PMID: 37734800 DOI: 10.1016/s2214-109x(23)00349-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Kaposi sarcoma is a rare, possibly angioproliferative, tumour. Kaposi sarcoma is one of the most common cancers in people living with HIV and poses a serious public health challenge in regions with high HIV burden. We aim to describe global patterns and population-wide trends in the burden of Kaposi sarcoma. METHODS In this population-based study, the incidence and mortality estimates of Kaposi sarcoma from 185 countries and regions in 2020 were extracted from the GLOBOCAN 2020 database. The time trends in Kaposi sarcoma incidence were evaluated using the cancer registry data from Cancer Incidence in Five Continents plus from 1998 to 2012. We did not apply any inclusion or exclusion criteria to the data used in this study. Joinpoint regression was used to evaluate the average annual percentage change (AAPC) to quantify trends in the age-standardised incidence rate (ASIR) of Kaposi sarcoma. Correlation analysis was used to evaluate the relationship between the ASIR or age-standardised mortality rate (ASMR) and Human Development Index (HDI). FINDINGS In 2020, the global estimated ASIR of Kaposi sarcoma was 0·39 (per 100 000 people), with an estimated 34 270 newly diagnosed cases (23 413 males and 10 857 females). An estimated 15 086 Kaposi sarcoma deaths were reported (9929 males and 5157 females), corresponding to an ASMR of 0·18 (per 100 000 people). In 2020, Africa accounted for 73·0% (25 010 of 34 270) of the incidence and 86·6% (13 066 of 15 086) of the deaths from Kaposi sarcoma worldwide. There was a significant correlation between the ASIR or ASMR and HDI. The incidence of Kaposi sarcoma increased in males in both Türkiye and the Netherlands. The AAPC was 11·5% (95% CI 3·2-20·4) for males in Türkiye and 2·5% (1·1-3·9) for males in the Netherlands from 1998 to 2012. The incidence of Kaposi sarcoma decreased in White Americans, Israel, Uganda, Costa Rica, Colombia, Canada, and Denmark, from 1998 to 2012. INTERPRETATION Kaposi sarcoma is a relatively rare cancer worldwide but is endemic in some countries in southern and eastern Africa. Addressing disparities in health-care resource allocation and improving HIV/AIDS care across different HDI regions might contribute to the prevention of Kaposi sarcoma. FUNDING The Natural Science Foundation of China Excellent Young Scientists Fund and the Natural Science Foundation of China International/Regional Research Collaboration Project. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yinghui Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Weijie Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuwei Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China; School of Public Health, Southwest Medical University, Luzhou, China; Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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Sabourin KR, Mugisha J, Asiki G, Nalwoga A, Labo N, Miley W, Beyer R, Rochford R, Johnston TW, Newton R, Whitby D. Epstein-Barr virus (EBV) antibody changes over time in a general population cohort in rural Uganda, 1992-2008. Infect Agent Cancer 2023; 18:55. [PMID: 37775773 PMCID: PMC10543268 DOI: 10.1186/s13027-023-00534-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Epstein-Barr virus (EBV) infection is ubiquitous and in sub-Saharan Africa, occurs early in life. In a population-based rural African cohort, we leveraged historical samples from the General Population Cohort (GPC) in Uganda to examine the epidemiology of infection with EBV over time, in the era of HIV. METHODS We used 9024 serum samples collected from the GPC in 1992, 2000, 2008, from 7576 participants across the age range (0-99 years of age) and tested for anti-EBV immunoglobulin G (IgG) antibodies to EAd, VCA, and EBNA-1 using a multiplex bead-based assay. The related gammaherpesvirus, Kaposi's sarcoma-associated herpesvirus (KSHV) seropositivity was also determined by detection of anti-KSHV IgG antibodies to K8.1 or ORF73 measured by recombinant protein enzyme-linked immunosorbent assay. Data on sex, age, and HIV serostatus were also collected. EBV seropositivity was modeled with age (excluding those under one year, who may have had maternal antibodies), sex, HIV serostatus, and KSHV serostatus using generalized linear mixed effects models to produce beta estimates. RESULTS More than 93% of children were EBV seropositive by one year of age. EBV seropositivity was significantly associated with KSHV seropositivity. Anti-EBNA-1 antibody levels decreased with increasing age and were lower on average in people living with HIV. In general, anti-EAd antibody levels increased with age, were higher in males and KSHV seropositive persons, but decreased over calendar time. Anti-VCA antibody levels increased with age and with calendar time and were higher in KSHV seropositive persons but lower in males. CONCLUSIONS This is the first study to identify factors associated with EBV antibodies across the entire life-course in rural sub-Saharan Africa. Consistent with other studies, EBV was near ubiquitous in the population by age one year. Patterns of antibodies show changes by age, sex and calendar time, but no association with HIV was evident, suggesting no relationship between EBV sero-epidemiology and the spread of HIV in the population over time in Uganda.
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Affiliation(s)
- Katherine R Sabourin
- Department of Immunology and Microbiology, CU School of Medicine, University of Colorado Anschutz Medical Campus, 12800 E. 19th Ave, RC1N P18-9403D, Aurora, CO, 80045, USA.
- UK Medical Research Council/ Uganda Virus Research Institute and London School of Health and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
| | - Joseph Mugisha
- UK Medical Research Council/ Uganda Virus Research Institute and London School of Health and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Gershim Asiki
- UK Medical Research Council/ Uganda Virus Research Institute and London School of Health and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- The African Population and Health Research Center, Nairobi, Kenya
| | - Angela Nalwoga
- Department of Immunology and Microbiology, CU School of Medicine, University of Colorado Anschutz Medical Campus, 12800 E. 19th Ave, RC1N P18-9403D, Aurora, CO, 80045, USA
- UK Medical Research Council/ Uganda Virus Research Institute and London School of Health and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Nazzarena Labo
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Wendell Miley
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Rachel Beyer
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Rosemary Rochford
- Department of Immunology and Microbiology, CU School of Medicine, University of Colorado Anschutz Medical Campus, 12800 E. 19th Ave, RC1N P18-9403D, Aurora, CO, 80045, USA
| | | | - Robert Newton
- UK Medical Research Council/ Uganda Virus Research Institute and London School of Health and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- University of York, York, UK
| | - Denise Whitby
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
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Nalwoga A, Marshall V, Miley W, Labo N, Whitby D, Newton R, Rochford R. Comparison of Epstein-Barr virus and Kaposi's sarcoma-associated herpesvirus viral load in peripheral blood mononuclear cells and oral fluids of HIV-negative individuals aged 3-89 years from Uganda. Infect Agent Cancer 2023; 18:38. [PMID: 37316814 DOI: 10.1186/s13027-023-00516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023] Open
Abstract
We previously found that age, sex and malaria were associated with KSHV in individuals from Uganda. In this study, we have evaluated these same factors in relation to EBV in the same specimens. Overall, 74% (oral fluids) and 46% (PBMCs) had detectable EBV. This was significantly higher than observed for KSHV (24% oral fluids and 11% PBMCs). Individuals with EBV in PBMCs were more likely to have KSHV in PBMCs (P = 0.011). The peak age for detection of EBV in oral fluids was 3-5 years while that of KSHV was 6-12 years. In PBMCs, there was a bimodal peak age for detection of EBV (at 3-5 years and 66 + years) while for KSHV there was a single peak at 3-5 years. Individuals with malaria had higher levels of EBV in PBMCs compared to malaria-negative individuals (P = 0.002). In summary, our results show that younger age and malaria are associated with higher levels of EBV and KSHV in PBMCs suggesting malaria impacts immunity to both gamma-herpesviruses.
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Affiliation(s)
- Angela Nalwoga
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Robert Newton
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
- University of York, York, UK.
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Saber M, Faghihi G, Seyedghafouri SA, Hosseini S. Mortality and cause of death in patients with dermatologic diseases: An 11-year record-based observational study. DERMATOL SIN 2023. [DOI: 10.4103/ds.ds-d-22-00134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Hansen ME, Mangusan R, Lurain K, Odeny T, George J, Lu C, Manion M, Widell A, Ekwede I, Whitby D, Gulley JL, Kadri SS, Elinoff JM, Barochia A, Torabi-Parizi P, Uldrick TS, Yarchoan R, Ramaswami R. Characteristics of patients admitted to the ICU with Kaposi sarcoma herpesvirus-associated diseases. AIDS 2022; 36:1969-1978. [PMID: 35848586 PMCID: PMC9617765 DOI: 10.1097/qad.0000000000003333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There are four conditions caused by Kaposi sarcoma herpesvirus (KSHV): Kaposi sarcoma, KSHV-associated multicentric Castleman disease (MCD), primary effusion lymphoma (PEL), and KSHV inflammatory cytokine syndrome (KICS). These KSHV-associated disorders (KADs) often occur in people with HIV and can lead to multiorgan dysfunction requiring admission to the ICU. However, little is known about patient outcomes in this setting. METHODS A retrospective study of patients with KADs admitted to the ICU between 2010 and 2021 was conducted, examining KAD admission diagnoses, HIV characteristics, selected cytokine profiles, and ICU interventions. Primary outcomes were 60-day and median overall survival from ICU admission to death from any cause. RESULTS Forty-seven patients (all but one with HIV coinfection) were included. At ICU admission, 44 patients (94%) were on antiretroviral therapy with a median CD4 + count of 88 cells/μl and HIV viral load of 23 copies/ml. The most common presentation was respiratory failure alone (19%) or with hypotension (17%). Twenty-two (47%) patients had presumed KICS (with or without Kaposi sarcoma) at admission and an additional KAD was diagnosed in 36% of these patients. IL-6 levels did not vary across KAD subtype. Twenty (43%) patients received KAD-directed therapy in the ICU. Sixty-day survival was 70% and median overall survival was 9 months. CONCLUSION The majority of patients with HIV and KADs admitted to the ICU had well controlled HIV. Additional KAD were diagnosed during ICU admission in a proportion of patients who presented with presumed KICS. Critical illness did not preclude a subset of patients from receiving KAD-directed therapy in the ICU.
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Affiliation(s)
- Megan E Hansen
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Ralph Mangusan
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Kathryn Lurain
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Thomas Odeny
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Jomy George
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Crystal Lu
- Pharmacy Department, Clinical Center, National Institutes of Health
| | - Maura Manion
- HIV Pathogenesis Section, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases
| | - Anaida Widell
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Irene Ekwede
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory
| | - James L Gulley
- Center for Immuno-oncology, Center for Cancer Research, National Cancer Institute
| | | | | | - Amisha Barochia
- Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Thomas S Uldrick
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Robert Yarchoan
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
| | - Ramya Ramaswami
- HIV/AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute
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11
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Casper C, Corey L, Cohen JI, Damania B, Gershon AA, Kaslow DC, Krug LT, Martin J, Mbulaiteye SM, Mocarski ES, Moore PS, Ogembo JG, Phipps W, Whitby D, Wood C. KSHV (HHV8) vaccine: promises and potential pitfalls for a new anti-cancer vaccine. NPJ Vaccines 2022; 7:108. [PMID: 36127367 PMCID: PMC9488886 DOI: 10.1038/s41541-022-00535-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023] Open
Abstract
Seven viruses cause at least 15% of the total cancer burden. Viral cancers have been described as the "low-hanging fruit" that can be potentially prevented or treated by new vaccines that would alter the course of global human cancer. Kaposi sarcoma herpesvirus (KSHV or HHV8) is the sole cause of Kaposi sarcoma, which primarily afflicts resource-poor and socially marginalized populations. This review summarizes a recent NIH-sponsored workshop's findings on the epidemiology and biology of KSHV as an overlooked but potentially vaccine-preventable infection. The unique epidemiology of this virus provides opportunities to prevent its cancers if an effective, inexpensive, and well-tolerated vaccine can be developed and delivered.
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Affiliation(s)
- Corey Casper
- Infectious Disease Research Institute, 1616 Eastlake Ave. East, Suite 400, Seattle, WA, 98102, USA
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institutes of Health, Bldg. 50, Room 6134, 50 South Drive, MSC8007, Bethesda, MD, 20892-8007, USA
| | - Blossom Damania
- Lineberger Comprehensive Cancer Center & Department of Microbiology and Immunology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, US
| | - Anne A Gershon
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University, 630 West 168th Street, New York, NY10032, US
| | - David C Kaslow
- PATH Essential Medicines, PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA, USA
| | - Laurie T Krug
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Jeffrey Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, HHS, 9609 Medical Center Dr, Rm. 6E118 MSC 3330, Bethesda, MD, 20892, USA
| | | | - Patrick S Moore
- Cancer Virology Program, Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
| | - Javier Gordon Ogembo
- Department of Immuno-Oncology, Beckman Research Institute of City of Hope, Duarte, CA, 91010, USA
| | - Warren Phipps
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center; Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Denise Whitby
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Charles Wood
- Department of Interdisciplinary Oncology, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
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12
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Sabourin KR, Nalwoga A, Whitby D, Newton R, Rochford R. Environmental determinants of Kaposi’s sarcoma-associated herpesvirus (KSHV) transmission in rural Uganda (ENDKU study): Contributions to research on KSHV infection and reactivation in African children; A longitudinal cohort study. Cancer Epidemiol 2022; 78:102154. [DOI: 10.1016/j.canep.2022.102154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 11/17/2022]
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13
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Zhang X, Fang Q, Zhu S, Wu X, HuangboYuan, Liu Z, Xu Y, Chen T, Zeng Y, Zhang T. Environmental risk factors and genetic markers of Kaposi's sarcoma associated herpesvirus infection among Uygur population in Xinjiang, China. J Med Virol 2022; 94:2755-2765. [PMID: 35043408 DOI: 10.1002/jmv.27600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/07/2022] [Accepted: 01/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Kaposi sarcoma-associated herpesvirus (KSHV) is endemic in Xinjiang, China. Determinants of KSHV seropositivity among high-risk groups are not well understood. We seek to identify genetic and environmental predisposing factors for KSHV infection among Uygurs in this endemic region. METHODS A cross-sectional study was performed among Uygur population in Xinjiang, China. KSHV-antibodies were detected using immunofluorescence assay (IFA) and human leukocyte antigen (HLA) alleles were genotyped. Univariate and multivariate logistic regression analysis were applied to explore the environmental and genetic risk factors of KSHV seropositivity. RESULTS A total of 721 participants were included. The seroprevalence of KSHV was 24.1% among this population. Sweet-food preference (OR 1.85, 95%CI 1.03-3.34), and coronary heart disease (OR 1.91, 95 %CI 1.24-2.94) were statistically correlated with KSHV infection. HLA-DQB1*06:09 were found to significantly increase the risk of KSHV infection under all 3 models (ORAllelic =4.06; ORDominant =3.27; ORRecessive =8.06). Six SNPs (SNP0260, SNP0361, SNP0797, SNP0852, SNP1159, SNP1375) in the DQB1 and DRB1 region and haploid type GTCTAACTAATC in block 17 were statistically associated with KSHV infection. CONCLUSION We demonstrated that genetic variations in HLA-DQB1/DRB1 and environmental risk factors were strongly associated with KSHV infection among this population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xin Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China.,Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Qiwen Fang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China.,Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Sibo Zhu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Xuefu Wu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - HuangboYuan
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Zhenqiu Liu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200438, China
| | - Yiyun Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China
| | - Tao Chen
- Xinjiang Ili center for diseases control and prevention, Xinjiang, China
| | - Yan Zeng
- Key Laboratory of Xinjiang Endemic and Ethnic Disease and Department of Biochemistry, School of Medicine, Shihezi University, 832000, Shihezi, Xinjiang, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China. Key Laboratory of Public Health Safety (Fudan University), Ministry of Education, China.,Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Yiwu Research Institue, Fudan University, Yiwu, China
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14
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Nalwoga A, Roshan R, Moore K, Marshall V, Miley W, Labo N, Nakibuule M, Cose S, Rochford R, Newton R, Whitby D. Kaposi's sarcoma-associated herpesvirus T cell responses in HIV seronegative individuals from rural Uganda. Nat Commun 2021; 12:7323. [PMID: 34916520 PMCID: PMC8677732 DOI: 10.1038/s41467-021-27623-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/02/2021] [Indexed: 11/09/2022] Open
Abstract
T cell responses to Kaposi's sarcoma-associated herpesvirus (KSHV) are likely essential in the control of KSHV infection and protection from associated disease, but remain poorly characterised. KSHV prevalence in rural Uganda is high at >90%. Here we investigate IFN- γ T cell responses to the KSHV proteome in HIV-negative individuals from a rural Ugandan population. We use an ex-vivo IFN- γ ELISpot assay with overlapping peptide pools spanning 83 KSHV open reading frames (ORF) on peripheral blood mononuclear cells (PBMC) from 116 individuals. KSHV-specific T cell IFN- γ responses are of low intensity and heterogeneous, with no evidence of immune dominance; by contrast, IFN- γ responses to Epstein-Barr virus, Cytomegalovirus and influenza peptides are frequent and intense. Individuals with KSHV DNA in PBMC have higher IFN- γ responses to ORF73 (p = 0.02) and lower responses to K8.1 (p = 0.004) when compared with those without KSHV DNA. In summary, we demonstrate low intensity, heterogeneous T cell responses to KSHV in immune-competent individuals.
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Affiliation(s)
- Angela Nalwoga
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
| | - Romin Roshan
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Kyle Moore
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | - Stephen Cose
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
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15
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Sabourin KR, Daud I, Ogolla S, Labo N, Miley W, Lamb M, Newton R, Whitby D, Rochford R. Malaria Is Associated With Kaposi Sarcoma-Associated Herpesvirus Seroconversion in a Cohort of Western Kenyan Children. J Infect Dis 2021; 224:303-311. [PMID: 33249494 PMCID: PMC8280487 DOI: 10.1093/infdis/jiaa740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/25/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We aimed to determine whether Plasmodium falciparum infection affects age of Kaposi sarcoma-associated herpesvirus (KSHV) seroconversion in Kenyan children. METHODS Kenyan children (n = 144) enrolled at age 1 month, from 2 sites with different levels of malaria transmission (stable/high vs unstable/low) were followed to age 24 months. Plasma was tested for KSHV antibodies using enzyme-linked immunosorbent assay (ELISA; K8.1 and LANA) and a multiplex bead-based assay (K8.1, K10.5, ORF38, ORF50, and LANA) and whole blood tested for P. falciparum DNA using quantitative PCR. Cox proportional hazards models were used to assess associations between P. falciparum DNA detection, malaria annualized rate (P. falciparum detections/person-years), and enrollment site (malaria-high vs malaria-low) with time to KSHV seroconversion. RESULTS KSHV seroprevalence was 63% by age 2 years when assessed by multiplex assay. Children with P. falciparum were at increased hazards of earlier KSHV seroconversion and, among children with malaria, the hazard of becoming KSHV seropositive increased significantly with increasing malaria annualized rate. Children from the malaria-high transmission region had no significant difference in hazards of KSHV seroconversion at 12 months but were more likely to become KSHV seropositive by age 24 months. DISCUSSION Malaria exposure increases the risk for KSHV seroconversion early in life.
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Affiliation(s)
- Katherine R Sabourin
- Department of Epidemiology, Colorado School of Public Health, Denver, Colorado, USA
- Department of Immunology and Microbiology, University of Colorado, Denver, Colorado, USA
| | - Ibrahim Daud
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Sidney Ogolla
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Nazzarena Labo
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Wendell Miley
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Molly Lamb
- Department of Epidemiology, Colorado School of Public Health, Denver, Colorado, USA
| | - Robert Newton
- Department of Health Sciences, University of York, York, United Kingdom
| | - Denise Whitby
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, Maryland, USA
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, Denver, Colorado, USA
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16
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Blumenthal MJ, Cornejo Castro EM, Whitby D, Katz AA, Schäfer G. Evidence for altered host genetic factors in KSHV infection and KSHV-related disease development. Rev Med Virol 2021; 31:e2160. [PMID: 33043529 PMCID: PMC8047912 DOI: 10.1002/rmv.2160] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/09/2023]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) is the etiological agent of Kaposi's sarcoma (KS), the most common AIDS-related malignancy. It also causes other rare, but certainly underreported, KSHV-associated pathologies, namely primary effusion lymphoma, multicentric Castleman disease and KSHV inflammatory cytokine syndrome. Epidemiology and pathogenicity studies point to the potential for host genetic predisposition to KSHV infection and/or the subsequent development of KSHV-associated pathologies partly explaining the peculiar geographic and population-specific incidence of KSHV and associated pathologies and discrepancies in KSHV exposure and infection and KSHV infection and disease development. This review consolidates the current knowledge of host genetic factors involved in the KSHV-driven pathogenesis. Studies reviewed here indicate a plausible connection between KSHV susceptibility and host genetic factors that affect either viral access to host cells via entry mechanisms or host innate immunity to viral infection. Subsequent to infection, KSHV-associated pathogenesis, reviewed here primarily in the context of KS, is likely influenced by an orchestrated concert of innate immune system interactions, downstream inflammatory pathways and oncogenic mechanisms. The association studies reviewed here point to interesting candidate genes that may prove important in achieving a more nuanced understanding of the pathogenesis and therapeutic targeting of KSHV and associated diseases. Recent studies on host genetic factors suggest numerous candidate genes strongly associated with KSHV infection or subsequent disease development, particularly innate immune system mediators. Taken together, these contribute toward our understanding of the geographic prevalence and population susceptibility to KSHV and KSHV-associated diseases.
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Affiliation(s)
- Melissa J. Blumenthal
- International Centre for Genetic Engineering and BiotechnologyCape TownSouth Africa
- Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical SciencesUniversity of Cape TownCape TownSouth Africa
- Institute of Infectious Disease and Molecular MedicineUniversity of Cape TownCape TownSouth Africa
| | - Elena Maria Cornejo Castro
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical ResearchFrederick National Laboratory for Cancer ResearchFrederickMarylandUSA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical ResearchFrederick National Laboratory for Cancer ResearchFrederickMarylandUSA
| | - Arieh A. Katz
- Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical SciencesUniversity of Cape TownCape TownSouth Africa
- Institute of Infectious Disease and Molecular MedicineUniversity of Cape TownCape TownSouth Africa
| | - Georgia Schäfer
- International Centre for Genetic Engineering and BiotechnologyCape TownSouth Africa
- Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical SciencesUniversity of Cape TownCape TownSouth Africa
- Institute of Infectious Disease and Molecular MedicineUniversity of Cape TownCape TownSouth Africa
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17
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Oluoch PO, Oduor CI, Forconi CS, Ong'echa JM, Münz C, Dittmer DP, Bailey JA, Moormann AM. Kaposi Sarcoma-Associated Herpesvirus Infection and Endemic Burkitt Lymphoma. J Infect Dis 2021; 222:111-120. [PMID: 32072172 DOI: 10.1093/infdis/jiaa060] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/18/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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). CONCLUSIONS 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.
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Affiliation(s)
- Peter O Oluoch
- 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
| | - Cliff I Oduor
- Kenya Medical Research Institute/Center for Global Health Research, Kisumu, Kenya.,Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Catherine S Forconi
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - John M Ong'echa
- Kenya Medical Research Institute/Center for Global Health Research, Kisumu, Kenya
| | - Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Dirk P Dittmer
- Department of Microbiology and Immunology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Ann M Moormann
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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18
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Kimuda SG, Andia-Biraro I, Sebina I, Egesa M, Nalwoga A, Smith SG, Bagaya BS, Levin J, Elliott AM, Raynes JG, Cose S. Mycobacterium tuberculosis infection is associated with increased B cell responses to unrelated pathogens. Sci Rep 2020; 10:14324. [PMID: 32868810 PMCID: PMC7458924 DOI: 10.1038/s41598-020-71044-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/05/2020] [Indexed: 01/12/2023] Open
Abstract
Antigens from Mycobacterium tuberculosis (M.tb), have been shown to stimulate human B cell responses to unrelated recall antigens in vitro. However, it is not known whether natural M.tb infection or whether vaccination with, Mycobacterium bovis BCG, has a similar effect. This study investigated the effects of M.tb infection and BCG vaccination on B cell responses to heterologous pathogen recall antigens. Antibodies against several bacterial and viral pathogens were quantified by ELISA in 68 uninfected controls, 62 individuals with latent TB infection (LTBI) and 107 active pulmonary TB (APTB) cases, and 24 recently BCG-vaccinated adolescents and naive controls. Antibody avidity was investigated using surface plasmon resonance and B cell ELISPOTs were used to measure plasmablast and memory B cell responses (MBC) in APTB cases and healthy donor controls. APTB was associated with higher levels of antibodies to respiratory syncytial virus and measles virus, compared to uninfected controls. BCG vaccination did not alter levels of antibodies against heterologous pathogens. Tetanus toxoid (TT)-specific antibody avidity was increased in APTB cases in comparison to uninfected individuals and the ratio of TT-specific plasmablasts to MBCs in the APTB cases was 7:1. M.tb infection is associated with increased antibody responses to heterologous pathogens in human subjects.
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Affiliation(s)
- Simon G Kimuda
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Irene Andia-Biraro
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ismail Sebina
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Moses Egesa
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Angela Nalwoga
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Steven G Smith
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Bernard S Bagaya
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jonathan Levin
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Alison M Elliott
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - John G Raynes
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Stephen Cose
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda. .,Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda. .,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
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19
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Nalwoga A, Nakibuule M, Marshall V, Miley W, Labo N, Cose S, Whitby D, Newton R. Risk Factors for Kaposi's Sarcoma-Associated Herpesvirus DNA in Blood and in Saliva in Rural Uganda. Clin Infect Dis 2020; 71:1055-1062. [PMID: 31555829 PMCID: PMC7428384 DOI: 10.1093/cid/ciz916] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/16/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Detectable Kaposi's sarcoma-associated herpesvirus (KSHV) DNA in blood and increased antibody titres may indicate KSHV reactivation, while the transmission of KSHV occurs via viral shedding in saliva. METHODS We investigated the risk factors for KSHV DNA detection by real-time polymerase chain reaction in blood and by viral shedding in saliva, in 878 people aged 3 to 89 years of both sexes in a rural Ugandan population cohort. Helminths were detected using microscopy and the presence of malaria parasitaemia was identified using rapid diagnostic tests. Regression modelling was used for a statistical analysis. RESULTS The KSHV viral load in blood did not correlate with the viral load in saliva, suggesting separate immunological controls within each compartment. The proportions of individuals with a detectable virus in blood were 23% among children aged 3-5 years and 22% among those 6-12 years, thereafter reducing with increasing age. The proportions of individuals with a detectable virus in saliva increased from 30% in children aged 3-5 years to 45% in those aged 6-12 years, and decreased subsequently with increasing age. Overall, 29% of males shed in saliva, compared to 19% of females (P = .008). CONCLUSIONS Together, these data suggest that young males may be responsible for much of the onward transmission of KSHV. Individuals with a current malaria infection had higher levels of viral DNA in their blood (P = .031), compared to uninfected individuals. This suggests that malaria may lead to KSHV reactivation, thereby increasing the transmission and pathogenicity of the virus.
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Affiliation(s)
- Angela Nalwoga
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marjorie Nakibuule
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Vickie Marshall
- Viral Oncology Section, Acquired Immunodeficiency Syndrome and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Wendell Miley
- Viral Oncology Section, Acquired Immunodeficiency Syndrome and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Nazzarena Labo
- Viral Oncology Section, Acquired Immunodeficiency Syndrome and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Denise Whitby
- Viral Oncology Section, Acquired Immunodeficiency Syndrome and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Robert Newton
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- University of York, York, United Kingdom
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20
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Sallah N, Miley W, Labo N, Carstensen T, Fatumo S, Gurdasani D, Pollard MO, Dilthey AT, Mentzer AJ, Marshall V, Cornejo Castro EM, Pomilla C, Young EH, Asiki G, Hibberd ML, Sandhu M, Kellam P, Newton R, Whitby D, Barroso I. Distinct genetic architectures and environmental factors associate with host response to the γ2-herpesvirus infections. Nat Commun 2020; 11:3849. [PMID: 32737300 PMCID: PMC7395761 DOI: 10.1038/s41467-020-17696-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 07/13/2020] [Indexed: 01/05/2023] Open
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) and Epstein-Barr Virus (EBV) establish life-long infections and are associated with malignancies. Striking geographic variation in incidence and the fact that virus alone is insufficient to cause disease, suggests other co-factors are involved. Here we present epidemiological analysis and genome-wide association study (GWAS) in 4365 individuals from an African population cohort, to assess the influence of host genetic and non-genetic factors on virus antibody responses. EBV/KSHV co-infection (OR = 5.71(1.58-7.12)), HIV positivity (OR = 2.22(1.32-3.73)) and living in a more rural area (OR = 1.38(1.01-1.89)) are strongly associated with immunogenicity. GWAS reveals associations with KSHV antibody response in the HLA-B/C region (p = 6.64 × 10-09). For EBV, associations are identified for VCA (rs71542439, p = 1.15 × 10-12). Human leucocyte antigen (HLA) and trans-ancestry fine-mapping substantiate that distinct variants in HLA-DQA1 (p = 5.24 × 10-44) are driving associations for EBNA-1 in Africa. This study highlights complex interactions between KSHV and EBV, in addition to distinct genetic architectures resulting in important differences in pathogenesis and transmission.
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MESH Headings
- Adolescent
- Adult
- Antibodies, Viral/biosynthesis
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Capsid Proteins/genetics
- Capsid Proteins/immunology
- Coinfection
- Disease Resistance/genetics
- Epstein-Barr Virus Infections/epidemiology
- Epstein-Barr Virus Infections/genetics
- Epstein-Barr Virus Infections/immunology
- Epstein-Barr Virus Infections/virology
- Epstein-Barr Virus Nuclear Antigens/genetics
- Epstein-Barr Virus Nuclear Antigens/immunology
- Female
- Gene Expression
- Genome-Wide Association Study
- HIV/genetics
- HIV/immunology
- HIV/pathogenicity
- HLA-DQ alpha-Chains/genetics
- HLA-DQ alpha-Chains/immunology
- Henipavirus Infections/epidemiology
- Henipavirus Infections/genetics
- Henipavirus Infections/immunology
- Henipavirus Infections/virology
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/immunology
- Herpesvirus 4, Human/pathogenicity
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/immunology
- Herpesvirus 8, Human/pathogenicity
- Host-Pathogen Interactions/genetics
- Host-Pathogen Interactions/immunology
- Humans
- Incidence
- Male
- Middle Aged
- Rural Population
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/genetics
- Sarcoma, Kaposi/immunology
- Sarcoma, Kaposi/virology
- Uganda/epidemiology
- Urban Population
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Affiliation(s)
- Neneh Sallah
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK.
- London School of Hygiene & Tropical Medicine, London, UK.
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Tommy Carstensen
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Segun Fatumo
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- London School of Hygiene & Tropical Medicine, London, UK
- MRC/UVRI at the London School of Hygiene & Tropical Medicine, Entebbe, Uganda
| | - Deepti Gurdasani
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Queen Mary University London, London, UK
| | - Martin O Pollard
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Alexander T Dilthey
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Alexander J Mentzer
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Elena M Cornejo Castro
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Cristina Pomilla
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Elizabeth H Young
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | | | | | - Paul Kellam
- Department of Infectious Diseases, Imperial College London, London, UK
- Kymab Ltd, Babraham Research Complex, Cambridge, UK
| | - Robert Newton
- MRC/UVRI at the London School of Hygiene & Tropical Medicine, Entebbe, Uganda
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Inês Barroso
- The Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK.
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
- Exeter Centre of ExcEllence in Diabetes (ExCEED), University of Exeter Medical School, Exeter, UK.
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21
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Nalwoga A, Webb EL, Muserere C, Chihota B, Miley W, Labo N, Elliott A, Cose S, Whitby D, Newton R. Variation in KSHV prevalence between geographically proximate locations in Uganda. Infect Agent Cancer 2020; 15:49. [PMID: 32714434 PMCID: PMC7376633 DOI: 10.1186/s13027-020-00313-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/15/2020] [Indexed: 01/25/2023] Open
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) transmission within endemic areas may vary. KSHV seroprevalence has been studied by different groups of researchers using different methods, making it difficult to make direct comparisons. Here we show results on KSHV seroprevalence using the same laboratory method from four different but geographically proximate populations in Uganda. Blood samples from the urban Entebbe Mother and Baby Study (EMaBS), the rural General Population Cohort (GPC), the fishing community Lake Victoria Island Intervention Study on Worms and Allergy related Diseases (LaVIISWA) and the high-risk sexual behaviour Good Health for Women Project (GHWP), were tested for IgG antibody levels to K8.1 and ORF73 recombinant proteins using ELISA. All adult participants of the EMaBS study and the GHWP were women, while the GPC (54% female) and LaVIISWA (52% female) studies had both males and females. EMaBS children were all 5 years of age while their mothers were 14 to 47 years of age. GHWP women were 15 to 45 years old, LaVIISWA participants were 1 to 72 years old while GPC participants were 1 to 103 years old. KSHV seropositivity varied in the different populations. In children aged 5 years, EMaBS had the lowest prevalence of 15% followed by GPC at 35% and LaVIISWA at 54%. In adult women, seropositivity varied from 69% (EMaBS) to 80% (LaVIISWA) to 87% (GPC) to 90% (GHWP). The reasons for the variation in prevalence are unclear but may reflect differences in the prevalence of cofactors between these four geographically proximate populations.
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Affiliation(s)
- Angela Nalwoga
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, CO USA
| | - Emily L Webb
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD USA
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD USA
| | - Alison Elliott
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen Cose
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene & Tropical Medicine, London, UK
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD USA
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22
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Lidenge SJ, Kossenkov AV, Tso FY, Wickramasinghe J, Privatt SR, Ngalamika O, Ngowi JR, Mwaiselage J, Lieberman PM, West JT, Wood C. Comparative transcriptome analysis of endemic and epidemic Kaposi's sarcoma (KS) lesions and the secondary role of HIV-1 in KS pathogenesis. PLoS Pathog 2020; 16:e1008681. [PMID: 32706839 PMCID: PMC7406108 DOI: 10.1371/journal.ppat.1008681] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/05/2020] [Accepted: 06/03/2020] [Indexed: 02/08/2023] Open
Abstract
In sub-Saharan Africa, endemic Kaposi's sarcoma (EnKS) is still prevalent despite high incidence of epidemic Kaposi's sarcoma (EpKS) resulting from the on-going HIV-1 epidemic. While KSHV is clearly the etiologic agent of KS, the mechanisms underlying KS development are not fully understood. For example, HIV-1 co-infection and concomitant immune dysfunction have been associated with EpKS development. However, the direct or indirect role(s) of HIV-1, and therefore of immune suppression, in EpKS remains unclear. How, or whether, EpKS is mechanistically distinct from EnKS is unknown. Thus, the absence of HIV-1 co-infection in EnKS provides a unique control for investigating and deciphering whether HIV-1 plays a direct or indirect role in the EpKS tumor microenvironment. We hypothesized that HIV-1 co-infection would induce transcriptome changes that differentiate EpKS from EnKS, thereby defining the direct intra-tumor role of HIV-1 in KS. Comparison of ART-treated and -naïve patients would further define the impact of ART on the KS transcriptome. We utilized RNA-seq followed by multiparameter bioinformatics analysis to compare transcriptomes from KS lesions to uninvolved control skin. We provide the first transcriptomic comparison of EpKS versus EnKS, ART-treated vs-naïve EpKS and male vs female EpKS to define the roles of HIV-1 co-infection, the impact of ART, and gender on KS gene expression profiles. Our findings suggest that ART-use and gender have minimal impact on transcriptome profiles of KS lesions. Gene expression profiles strongly correlated between EpKS and EnKS patients (Spearman r = 0.83, p<10-10). A subset of genes involved in tumorigenesis and inflammation/immune responses showed higher magnitude, but not unique dysregulation in EnKS compared to EpKS. While gender and ART had no detectable contribution, the trend toward higher magnitude of gene dysregulation in EnKS coupled with the absence of HIV-1 transcripts in EpKS may suggest an indirect or systemic effect of HIV-1 to promote KS tumorigenesis.
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Affiliation(s)
- Salum J. Lidenge
- Nebraska Center for Virology and the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska, United States of America
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - For Yue Tso
- Nebraska Center for Virology and the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska, United States of America
| | | | - Sara R. Privatt
- Nebraska Center for Virology and the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska, United States of America
| | - Owen Ngalamika
- Dermatology and Venereology section, University Teaching Hospitals, University of Zambia School of Medicine, Lusaka, Zambia
| | - John R. Ngowi
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Julius Mwaiselage
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paul M. Lieberman
- Wistar Institute, Philadelphia, Pennsylvania, United States of America
| | - John T. West
- Nebraska Center for Virology and the Department of Biochemistry, University of Nebraska, Lincoln, Nebraska, United States of America
| | - Charles Wood
- Nebraska Center for Virology and the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska, United States of America
- Nebraska Center for Virology and the Department of Biochemistry, University of Nebraska, Lincoln, Nebraska, United States of America
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23
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Viral and Immunological Analytes are Poor Predictors of the Clinical Treatment Response in Kaposi's Sarcoma Patients. Cancers (Basel) 2020; 12:cancers12061594. [PMID: 32560243 PMCID: PMC7352224 DOI: 10.3390/cancers12061594] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/07/2020] [Accepted: 06/12/2020] [Indexed: 12/26/2022] Open
Abstract
Kaposi’s sarcoma-associated herpes virus (KSHV) is the etiologic agent for Kaposi’s sarcoma (KS). The prognostic utility of KSHV and HIV-1 (human immunodeficiency virus) viremia as well as immunological parameters in clinical management of participants with KS is unclear. The objective of this study was to investigate viral and immunological parameters as predictors of KS treatment responses in participants with KS from sub-Saharan Africa (SSA). Plasma KSHV-DNA, HIV-1 viral load, total anti-KSHV antibody, KSHV-neutralizing antibody (nAb), cytokine/chemokine levels, and T-cell differentiation subsets were quantified before and after KS treatment in 13 participants with KS and in 13 KSHV-infected asymptomatic control individuals. One-way analysis of variance and the Mann-Whitney t-test were used to assess differences between groups where p-values < 0.05 were considered significant. Subjects with patch and plaque KS lesions responded more favorably to treatment than those with nodular lesions. Pre-treatment and post-treatment levels of plasma KSHV-DNA, HIV-1 viral load, KSHV-Ab responses, cytokines, and T-cell populations did not predict the KS treatment response. Elevated KSHV-humoral and cytokine responses persisted in participants with KS despite a clinical KS response. While patch and plaque KS lesions were more common among treatment responders, none of the analyzed viral and immunological parameters distinguished responders from non-responders at baseline or after treatment.
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24
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Prevalence of Kaposi's sarcoma-associated herpesvirus and transfusion-transmissible infections in Tanzanian blood donors. Int J Infect Dis 2020; 95:204-209. [PMID: 32294540 DOI: 10.1016/j.ijid.2020.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Kaposi's sarcoma-associated herpesvirus (KSHV) is the causative agent for Kaposi's sarcoma (KS), one of the most common cancers in Tanzania. We have investigated KSHV prevalence and factors associated with KSHV infection in Tanzania. METHODS This is a cross-sectional study of voluntary blood-donors from Dar es Salaam, Tanzania. Plasma was screened for KSHV, HIV-1, HBV, HCV and Treponema pallidum (syphilis). Associations between KSHV sero-status and risk factors were analyzed. Odds ratios (OR) and 95% confidence intervals (CI) are reported to evaluate risk factors of KSHV infection. All tests were 2-tailed, and P-values <0.05 were considered statistically significant. RESULTS The overall KSHV seroprevalence was 56.9%. Significantly increased risk of KSHV infection was detected in persons from the Lake and Central Zones (OR=6.4, 95% CI=1.6-25.3, P=0.008 and OR=5.7, 95% CI=1.0-32.5, P=0.048 respectively). A trend toward increased risk of KSHV infection with HIV-1 co-infection was not significant (OR=2.8, 95% CI=1.0-8.0, P=0.06). Seroreactivity to T. pallidum was surprisingly high (14.9%). CONCLUSION The prevalence of KSHV infection and syphilis was high among Tanzanian blood-donors. The most common transfusion-transmissible infections did not associate with KSHV infection. Regions of focal KSHV infection need further investigation for underappreciated risk factors.
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25
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Lidenge SJ, Tso FY, Ngalamika O, Ngowi JR, Mortazavi Y, Kwon EH, Shea DM, Minhas V, Mwaiselage J, Wood C, West JT. Similar Immunological Profiles Between African Endemic and Human Immunodeficiency Virus Type 1-Associated Epidemic Kaposi Sarcoma (KS) Patients Reveal the Primary Role of KS-Associated Herpesvirus in KS Pathogenesis. J Infect Dis 2020; 219:1318-1328. [PMID: 30452681 DOI: 10.1093/infdis/jiy654] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 11/09/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Kaposi sarcoma (KS)-associated herpesvirus (KSHV) is etiologically linked to all KS forms, but mechanisms underlying KS development are unclear. The incidence of KS in human immunodeficiency virus type 1-infected (HIV-1+) individuals implicates immune dysregulation; however, the lack of characterization of KSHV immune responses in endemic KS makes the role of HIV-1 unclear. The study objective was to investigate the HIV-1 and KSHV roles in viral nucleic acid detection, antibody responses, and cytokine responses in polymerase chain reaction-confirmed epidemic KS and endemic KS patients and non-cancer controls from sub-Saharan Africa. METHODS KSHV viral DNA (vDNA), total anti-KSHV antibody, KSHV neutralizing antibody (nAb), and cytokines were quantified. RESULTS KSHV vDNA was detectable in tumors but variably in plasma and peripheral blood mononuclear cells. Consistent with elevated antibody-associated cytokines (interleukin [IL] 6, IL-5, and IL-10), nAb titers were higher in epidemic KS and endemic KS patients than in controls (P < .05). Despite HIV-1 coinfection in epidemic KS, nAb titers were similar between epidemic KS and endemic KS patients (P = 0.3). CONCLUSIONS Similarities in antibody and cytokine responses between epidemic and endemic KS patients suggest that KSHV drives KS pathogenesis, whereas HIV-1 exacerbates it.
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Affiliation(s)
- Salum J Lidenge
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania.,School of Biological Sciences, University of Nebraska-Lincoln, Dar es Salaam, Tanzania.,Ocean Road Cancer Institute, Dar es Salaam, Tanzania.,Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - For Yue Tso
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania.,School of Biological Sciences, University of Nebraska-Lincoln, Dar es Salaam, Tanzania
| | - Owen Ngalamika
- Dermatology and Venereology Section, University Teaching Hospitals, University of Zambia School of Medicine, Lusaka
| | - John R Ngowi
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Yasaman Mortazavi
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania.,School of Biological Sciences, University of Nebraska-Lincoln, Dar es Salaam, Tanzania
| | - Eun Hee Kwon
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania
| | - Danielle M Shea
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania
| | - Veenu Minhas
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha
| | - Julius Mwaiselage
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania.,Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Charles Wood
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania.,School of Biological Sciences, University of Nebraska-Lincoln, Dar es Salaam, Tanzania
| | - John T West
- Nebraska Center for Virology, University of Nebraska-Lincoln, Dar es Salaam, Tanzania
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26
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Association of NFκB and related-cytokines with the viral load and development of antibodies against HHV-8 in people living with HIV/AIDS. Med Microbiol Immunol 2019; 209:41-49. [PMID: 31586222 DOI: 10.1007/s00430-019-00637-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/23/2019] [Indexed: 02/08/2023]
Abstract
Human gammaherpesvirus 8 (HHV-8) replication is influenced by a complex interaction between viral and host elements. Here, we evaluated the expression of NFκB and TNF-α in B (CD19 +) and T (CD3 +) lymphocytes, and the serum concentration of IL-1β and IL-12 cytokines in people living with HIV/AIDS (PLHA), negative for HHV-8-related diseases, and who presented antibodies to latent or lytic antigens from HHV-8. In addition, we also evaluated the correlation of HHV-8 viral load with NFκB, TNF-α, IL-1β and IL-12 levels. The expression of NFκB (p < 0.0001) or TNF-α (p < 0.0001) in B lymphocytes (CD19 +) and the IL-1β (p < 0.0266) and IL-12 (p < 0.0001) concentrations were associated with the presence of antibodies to HHV-8 lytic antigens. The CD19 + NFκB + TNF-α + and CD3 + NFκB + TNF-α + cells were also associated with the presence of antibodies to lytic infection (p < 0.0001). Among all PLHA evaluated, only individuals with the highest titers of lytic antibodies, i.e., 1:320, had detectable HHV-8 viral load. In these, HHV-8 viral load was correlated to NFκB (r = 0.6, p = 0.003) and TNF-α (r = 0.5, p = 0.01) (both in CD19 + lymphocytes) and with IL-1β (r = 0.5, p = 0.01) and IL-12 (r = 0.6, p = 0.006) levels. We believe that viral replication and/or reactivation, in addition to being associated with the development of lytic antibodies against HHV-8, may be associated with inflammatory response via NFκB. Finally, although immune response imbalance has been previously related to HHV-8-associated diseases, our results indicate that important changes in immunity, mainly in the inflammatory response, may be clearly observed in individuals with HHV-8, but who have not yet presented clinical manifestations.
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27
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Nalwoga A, Webb EL, Chihota B, Miley W, Walusimbi B, Nassuuna J, Sanya RE, Nkurunungi G, Labo N, Elliott AM, Cose S, Whitby D, Newton R. Kaposi's sarcoma-associated herpesvirus seropositivity is associated with parasite infections in Ugandan fishing communities on Lake Victoria islands. PLoS Negl Trop Dis 2019; 13:e0007776. [PMID: 31618208 PMCID: PMC6816576 DOI: 10.1371/journal.pntd.0007776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 10/28/2019] [Accepted: 09/11/2019] [Indexed: 12/20/2022] Open
Abstract
We investigated the impact of helminths and malaria infection on Kaposi's sarcoma associated herpesvirus (KSHV) seropositivity, using samples and data collected from a cluster-randomised trial of intensive versus standard anthelminthic treatment. The trial was carried out in 2012 to 2016 among fishing communities on Lake Victoria islands in Uganda. Plasma samples from 2881 participants from two household surveys, the baseline (1310 participants) and the final (1571 participants) surveys were tested for KSHV IgG antibody responses to K8.1 and ORF73 recombinant proteins using ELISA. The baseline survey was carried out before the trial intervention while the final survey was carried out after three years of the trial intervention. Additionally, a subset sample of 372 participants from the final survey was tested for IgE, IgG and IgG4 antibody concentrations to S. mansoni adults worm antigen (SWA) and S. mansoni egg antigen (SEA) using ELISA. Infection by helminths (S. mansoni, N. americanus, T. trichiura and S. stercoralis) was diagnosed using real-time PCR, urine circulating cathodic antigen (CCA) and stool microscopy (Kato-Katz method) while malaria infection was diagnosed using microscopy. We analysed the relationship between helminth and malaria infections and KSHV seropositivity using regression modelling, allowing for survey design. At baseline, 56% of the participants were male while 48% of the participants were male in the final survey. The most prevalent helminth infection was S. mansoni (at baseline 52% and 34% in the final survey by microscopy, 86% by CCA and 50% by PCR in the final survey). KSHV seropositivity was 66% (baseline) and 56% (final survey) among those 1-12 years and >80% in those 13+ years in both surveys; malaria parasitaemia prevalence was 7% (baseline) and 4% (final survey). At baseline, individuals infected with S. mansoni (detected by microscopy) were more likely to be KSHV seropositive (aOR = 1.86 (1.16, 2.99) p = 0.012) and had higher anti-K8.1 antibody levels (acoefficient = 0.03 (0.01, 0.06) p = 0.02). In the final survey, S. mansoni (by microscopy, adjusted Odds Ratio (aOR = 1.43 (1.04-1.95), p = 0.028) and malaria parasitaemia (aOR = 3.49 (1.08-11.28), p = 0.038) were positively associated with KSHV seropositivity. Additionally, KSHV seropositive participants had higher S. mansoni-specific IgE and IgG antibody concentrations in plasma. Furthermore, HIV infected individuals on cART were less likely to be KSHV seropositive compared to HIV negative individuals (aOR = 0.46 (0.30, 0.71) p = 0.002). Schistosoma species skew the immune response towards Th2 and regulatory responses, which could impact on KSHV reactivation if co-infected with both organisms.
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Affiliation(s)
- Angela Nalwoga
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Emily L. Webb
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Belinda Chihota
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | | | | | - Richard E. Sanya
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gyaviira Nkurunungi
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Alison M. Elliott
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Stephen Cose
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Robert Newton
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- University of York, York; United Kingdom
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Nalwoga A, Cose S, Nash S, Miley W, Asiki G, Kusemererwa S, Yarchoan R, Labo N, Whitby D, Newton R. Relationship Between Anemia, Malaria Coinfection, and Kaposi Sarcoma-Associated Herpesvirus Seropositivity in a Population-Based Study in Rural Uganda. J Infect Dis 2019; 218:1061-1065. [PMID: 29741631 DOI: 10.1093/infdis/jiy274] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 05/07/2018] [Indexed: 02/07/2023] Open
Abstract
We examined anemia and malaria as risk factors for Kaposi sarcoma-associated herpesvirus (KSHV) seropositivity and antibody levels in a long-standing rural Ugandan cohort, in which KSHV is prevalent. Samples from 4134 children, aged 1-17 years, with a sex ratio of 1:1, and 3149 adults aged 18-103 years, 41% of whom were males, were analyzed. Among children, malaria infection was associated with higher KSHV prevalence (61% vs 41% prevalence among malaria infected and uninfected, respectively); malaria was not assessed in adults. Additionally, lower hemoglobin level was associated with an increased prevalence of KSHV seropositivity, both in children and in adults.
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Affiliation(s)
- Angela Nalwoga
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, United Kingdom
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, United Kingdom
| | - Stephen Nash
- London School of Hygiene and Tropical Medicine, United Kingdom
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, MD
| | - Gershim Asiki
- African Population and Health Research Centre, Nairobi, Kenya
| | - Sylvia Kusemererwa
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Robert Yarchoan
- HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, MD
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, MD
| | - Robert Newton
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,University of York, United Kingdom
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Labo N, Marshall V, Miley W, Davis E, McCann B, Stolka KB, Ndom P, Hemingway-Foday JJ, Abassora M, Newton R, Smith JS, Whitby D. Mutual detection of Kaposi's sarcoma-associated herpesvirus and Epstein-Barr virus in blood and saliva of Cameroonians with and without Kaposi's sarcoma. Int J Cancer 2019; 145:2468-2477. [PMID: 31265124 DOI: 10.1002/ijc.32546] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/24/2019] [Accepted: 06/14/2019] [Indexed: 02/06/2023]
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) and Epstein-Barr virus (EBV) are prevalent in sub-Saharan Africa, together with HIV; the consequent burden of disease is grave. The cofactors driving transmission of the two viruses and pathogenesis of associated malignancies are not well understood. We measured KSHV and EBV DNA in whole blood and saliva as well as serum antibodies levels in 175 Cameroonians with Kaposi's sarcoma and 1,002 age- and sex-matched controls with and without HIV. KSHV seroprevalence was very high (81%) in controls, while EBV seroprevalence was 100% overall. KSHV DNA was detectable in the blood of 36-46% of cases and 6-12% of controls; EBV DNA was detected in most participants (72-89%). In saliva, more cases (50-58%) than controls (25-28%) shed KSHV, regardless of HIV infection. EBV shedding was common (75-100%); more HIV+ than HIV- controls shed EBV. Cases had higher KSHV and EBV VL in blood and saliva then controls, only among HIV+ participants. KSHV and EBV VL were also higher in HIV+ than in HIV- controls. Cases (but not controls) were more likely to have detectable KSHV in blood if they also had EBV, whereas shedding of each virus in saliva was independent. While EBV VL in saliva and blood were modestly correlated, no correlation existed for KSHV. Numerous factors, several related to parasitic coinfections, were associated with detection of either virus or with VL. These findings may help better understand the interplay between the two gammaherpesviruses and generally among copathogens contributing to cancer burden in sub-Saharan Africa.
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Affiliation(s)
- Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc. Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc. Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc. Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Eliza Davis
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc. Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Brendan McCann
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc. Frederick National Laboratory for Cancer Research, Frederick, MD
| | | | | | | | | | - Robert Newton
- University of York, York, United Kingdom.,MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Inc. Frederick National Laboratory for Cancer Research, Frederick, MD
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Abstract
Kaposi sarcoma (KS) gained public attention as an AIDS-defining malignancy; its appearance on the skin was a highly stigmatizing sign of HIV infection during the height of the AIDS epidemic. The widespread introduction of effective antiretrovirals to control HIV by restoring immunocompetence reduced the prevalence of AIDS-related KS, although KS does occur in individuals with well-controlled HIV infection. KS also presents in individuals without HIV infection in older men (classic KS), in sub-Saharan Africa (endemic KS) and in transplant recipients (iatrogenic KS). The aetiologic agent of KS is KS herpesvirus (KSHV; also known as human herpesvirus-8), and viral proteins can induce KS-associated cellular changes that enable the virus to evade the host immune system and allow the infected cell to survive and proliferate despite viral infection. Currently, most cases of KS occur in sub-Saharan Africa, where KSHV infection is prevalent owing to transmission by saliva in childhood compounded by the ongoing AIDS epidemic. Treatment for early AIDS-related KS in previously untreated patients should start with the control of HIV with antiretrovirals, which frequently results in KS regression. In advanced-stage KS, chemotherapy with pegylated liposomal doxorubicin or paclitaxel is the most common treatment, although it is seldom curative. In sub-Saharan Africa, KS continues to have a poor prognosis. Newer treatments for KS based on the mechanisms of its pathogenesis are being explored.
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Affiliation(s)
- Ethel Cesarman
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Blossom Damania
- Department of Microbiology and Immunology, Lineberger Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | - Jeffrey Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Mark Bower
- National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London, UK
| | - Denise Whitby
- Leidos Biomedical Research, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
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31
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Yuan H, Liu Z, Wu X, Fang Q, Zheng J, Zeng Y, Zhang T. Social behavioral correlates of Kaposi sarcoma-associated herpesvirus infection among Han and Uygur populations in Xinjiang, China. J Med Virol 2018; 91:457-462. [DOI: 10.1002/jmv.25332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/26/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Huangbo Yuan
- Department of Epidemiology; School of Public Health, Fudan University; Shanghai China
- Key Laboratory of Public Health Safety; Ministry of Education, Fudan University; Shanghai China
| | - Zhenqiu Liu
- Department of Epidemiology; School of Public Health, Fudan University; Shanghai China
- Key Laboratory of Public Health Safety; Ministry of Education, Fudan University; Shanghai China
| | - Xuefu Wu
- Department of Epidemiology; School of Public Health, Fudan University; Shanghai China
- Key Laboratory of Public Health Safety; Ministry of Education, Fudan University; Shanghai China
| | - Qiwen Fang
- Department of Epidemiology; School of Public Health, Fudan University; Shanghai China
- Key Laboratory of Public Health Safety; Ministry of Education, Fudan University; Shanghai China
| | - Jun Zheng
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Department of Biochemistry; Shihezi University School of Medicine; Shihezi China
| | - Yan Zeng
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Department of Biochemistry; Shihezi University School of Medicine; Shihezi China
| | - Tiejun Zhang
- Department of Epidemiology; School of Public Health, Fudan University; Shanghai China
- Key Laboratory of Public Health Safety; Ministry of Education, Fudan University; Shanghai China
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