DETECTION OF HUMAN HERPESVIRUS-8 ANTIGEN IN HIV-INFECTED PATIENTS IN EAST JAVA, INDONESIA

The Emergence of HHV-8 Infection among HIV-positive Individuals Residing in Bali, Indonesia

Background: Human herpesvirus 8 (HHV-8) is considered as the etiological agent of Kaposi’s sarcoma (KS). In people living with human immunodeficiency virus (HIV) (PLHIV), KS defines acquired immunodeficiency syndrome (AIDS). Previous study found that HIV-positive individuals were more likely to be HHV-8 seropositive than HIV-negative individuals. Reports regarding the presence of HHV-8 and HIV co-infection in Indonesia is severely limited.   Aim: This study aimed to identify HHV-8 infection among HIV-positive individuals in Bali, Indonesia. Materials and Methods: Forty three plasma samples were collected from 16 antiretroviral therapy (ART) naive and 27 ART-experienced individuals residing in Buleleng Regency, Bali, Indonesia. Detection of HHV-8 antigen was performed by using ELISA method. The Fisher's Exact test and the Spearman correlation test would be used to analysed data accordingly. Results: Seven samples (7/43, 16.3%), one of ART-naive individual (1/16, 6.25%) and six of ART-experienced individuals (6/27, 22.2%), were tested positive for HHV-8 antigen. Human herpesvirus 8 infection was correlated neither to sex (p=1.000) and age (p=0.716), nor to ART status (p=0.178) and length of ART (p=0.465). Conclusion: This study indicates the emergence of HHV-8 infection among HIV-positive individuals residing in Bali, Indonesia. Sufficient diagnosis of HHV-8 should be considered for all HIV-positive individuals in order to deliver appropriate treatment. Extensive researches is suggested to be conducted in more regions of Indonesia in order to determine the magnitude of HHV-8 infection among HIV-positive individuals.

The previously common post-kidney transplant Kaposi sarcoma has become non-existent for a decade: an Egyptian experience

BACKGROUND

De novo malignancy is a worrying complication after kidney transplantation; the type of which may vary due to factors such as the prevalence of viral infection and race. Kaposi sarcoma used to be the most common malignancy among our patients constituting more than one-third of cancers. Nevertheless, we noticed that Kaposi sarcoma has not been observed for a long period. Therefore, we conducted this study to explore such observation.

METHODS

Data of all kidney transplant recipients were retrieved and retrospectively analyzed. Their total number was 3126 patients. Their mean age was 28.71 ± 10.97 years and of them, 823 (26.3%) were females. The pattern of Kaposi sarcoma throughout the last decade as well as the preceding three decades was studied. The possible relation between the disappearance of Kaposi sarcoma and three paradigm shifts in our practice, namely the use of mTOR inhibitors, steroid-free regimen and CMV prophylaxis was explored.

RESULTS

Since 2010, no new cases of Kaposi sarcoma have been observed. In addition, patients who have been transplanted after 2006 did not develop such malignancy. Patients who received CMV prophylaxis and/or were maintained on mTOR inhibitor or steroid-free regimens have not developed Kaposi sarcoma. Moreover, CMV prophylaxis had a statistically significant difference when compared to a homogenous group without CMV prophylaxis. However, Kaplan-Meier analysis of patients of the three policies and their counterpart groups showed comparable results.

CONCLUSION

Kaposi sarcoma, which was previously the most common malignancy, is no longer observed for almost a decade among our kidney transplant recipients. m-TOR inhibitors, steroid-free regimen and CMV prophylaxis policy are possible contributing factors. Nevertheless, only CMV prophylaxis policy had a statistically significant relation to the disappearance of Kaposi sarcoma.

Human herpes virus 8 antibodies in HIV-positive patients in Surabaya, Indonesia

Background

Human herpesvirus 8 (HHV-8) infection is etiologically related to Kaposi’s sarcoma. Antibodies directed against HHV-8 can be detected in 80-95% of HIV-seropositive patients with KS. HHV-8 serological tests have been done in several countries in Southeast Asia such as Malaysia, and Thailand however no serological data is available in Indonesia. This study was to examine the presence of HHV- 8 antibodies in HIV-positive patients in Surabaya, Indonesia.

Material and methods

Ninety-one serum samples were collected from HIVpositive patients in Surabaya, Indonesia. Human immunodeficiency virus-positive serum samples were collected from 10 homosexual men, 25 intravenous drug users (IVDUs) and 56 heterosexuals. Serums were then tested for the presence of HHV-8 antibody by using sandwich ELISA (Abbexa Ltd, Cambridge, UK).

Results

The total of 91 HIV-infected were testing with antibodies to HHV-8 using enzyme-linked immunosorbent assay. Antibodies of HHV-8 were detected in 7/91 (7.7%) of the samples. According to a gender, six men (85.7%) and a women (14.3%) were positive of HHV-8 antibodies. No correlation regarding the gender and age from this study. The antibodies of HHV-8 was detected among intravenous drug users (IVDUs) men 5/7 (42.8%) and 2/7 (28.6%) from homosexual and heterosexual, respectively.

Conclusion

This study found the presence of HHV-8 antibodies in 7.7% of patients in Surabaya, Indonesia. This finding was higher more than Southeast Asian countries. The patients with a positive result could suggest measures to prevent HHV-8 infection.