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Serologic screening and molecular surveillance of Kaposi sarcoma herpesvirus (KSHV)/human herpesvirus-8 (HHV-8) infections for early recognition and effective treatment of KSHV-associated inflammatory cytokine syndrome (KICS) in solid organ transplant recipients.
American Journal of Transplantation ( IF 8.9 ) Pub Date : 2024-11-15 , DOI: 10.1016/j.ajt.2024.11.013
Alessandra Mularoni,Andrea Cona,Matteo Bulati,Rosalia Busà,Monica Miele,Francesca Timoneri,Mariangela Di Bella,Salvatore Castelbuono,Floriana Barbera,Daniele Di Carlo,Lorenzo Volpe,Alessia Gallo,Anna Maria de Luca,Giulia Coniglione,Francesca Todaro,Patrizia Barozzi,Giovanni Riva,Giada Pietrosi,Salvatore Gruttadauria,Alessandro Bertani,Patrizio Vitulo,Alessandra Fontana,Manlio Cipriani,Sergio Rizzo,Antonio Arcadipane,Angelo Luca,Malgorzata Mikulska,Pier Giulio Conaldi,Paolo Antonio Grossi,Mario Luppi

Kaposi sarcoma herpesvirus/human herpesvirus-8 (HHV-8) neoplastic and non-neoplastic disease in solid organ transplant (SOT) recipients can be life-threatening. We evaluated the seroprevalence of HHV-8 infection among donors (D) and recipients (R), the incidence of HHV-8 transmission/reactivation, and the clinical characteristics, management, and outcomes of HHV-8-related diseases, including Kaposi sarcoma herpesvirus-associated inflammatory cytokine syndrome (KICS), in consecutive SOT patients from 2011 to 2023. HHV-8 seroprevalence was 3.3% in 1349 donors and 8.4% in 1856 recipients screened (p<0.0001). Among the D+/R- group (n=49), 13 patients developed HHV-8-related diseases: 7 liver recipients had KICS, and 1 lung recipient had Kaposi sarcoma (KS) with subsequent KICS. Four KICS patients treated with rituximab survived, while the 3 patients not treated with rituximab died. Within the D-/R- group, out of 5 (0.3%) patients with non-donor-derived primary HHV-8 infection, 3 liver recipients developed KICS. In the R+ patients (n=155), 3 developed KS. In our cohort, 25/944 (2.6%) liver transplant recipients had a primary HHV-8 infection, and 10 of them (40%) developed KICS; 40% (4/10) of HHV-8 seropositive heart transplant recipients developed reactivation and 2 of them (50%) had fatal KS. Serologic screening and molecular surveillance of D+/R- patient groups facilitate early recognition and effective therapy of KICS.

中文翻译:


卡波西肉瘤疱疹病毒 (KSHV)/人疱疹病毒 8 (HHV-8) 感染的血清学筛查和分子监测,用于早期识别和有效治疗实体器官移植受者的 KSHV 相关炎性细胞因子综合征 (KICS)。



实体器官移植 (SOT) 受者中的卡波西肉瘤疱疹病毒/人疱疹病毒 8 (HHV-8) 肿瘤和非肿瘤疾病可能危及生命。我们评估了 2011 年至 2023 年连续 SOT 患者 HHV-8 感染在供体 (D) 和受体 (R) 中血清阳性率、HHV-8 传递/再激活的发生率以及 HHV-8 相关疾病的临床特征、管理和结果,包括卡波西肉瘤疱疹病毒相关炎性细胞因子综合征 (KICS)。HHV-8 血清阳性率在 1349 名供体中为 3.3%,在筛选的 8.4 名受者中为 1856% (p<0.0001)。在 D+/R- 组 (n=49) 中,13 例患者发生 HHV-8 相关疾病: 7 例肝脏受者患有 KICS,1 例肺受者患有卡波西肉瘤 (KS) 并随后发生 KICS。4 例接受利妥昔单抗治疗的 KICS 患者存活,而 3 例未接受利妥昔单抗治疗的患者死亡。在 D-/R- 组中,在 5 名 (0.3%) 非供体来源的原发性 HHV-8 感染患者中,3 名肝脏受者发生了 KICS。在 R+ 患者 (n=155) 中,3 例发生 KS。在我们的队列中,25/944 (2.6%) 的肝移植受者患有原发性 HHV-8 感染,其中 10 例 (40%) 发展为 KICS;40% (4/10) 的 HHV-8 血清阳性心脏移植受者发生再激活,其中 2 例 (50%) 患有致命性 KS。D+/R- 患者群体的血清学筛查和分子监测有助于 KICS 的早期识别和有效治疗。
更新日期:2024-11-15
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