Patients with epidemic and endemic Kaposi Sarcoma (KS) have similar antibody and cytokine responses, suggesting that KS-associated herpes virus drives Kaposi Sarcoma pathogenesis, according to results published in the Journal of Infectious Diseases.

The results also suggest that HIV-1 coinfection exacerbates and accelerates KS-associated herpes virus pathogenesis and KS development.

The study included participants with epidemic- Kaposi Sarcoma, endemic- Kaposi Sarcoma, and noncancer control patients from sub-Saharan Africa. The researchers quantified Kaposi Sarcoma -associated herpes viral-DNA, total anti- Kaposi Sarcoma-associated herpes virus antibody, Kaposi Sarcoma -associated herpes virus-neutralizing antibody, and cytokines. The study investigators used the Mann-Whitney U-test to assess differences between groups.

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In total, the study included 51 participants with Kaposi Sarcoma (34 epidemic-Kaposi Sarcoma and 17 endemic-Kaposi Sarcoma) and 80 noncancer control patients. Participants with Kaposi Sarcoma were newly diagnosed, histologically confirmed, and polymerase chain reaction confirmed. HIV-1 diagnosis was made according to Tanzania HIV Rapid Test Algorithm and Alere Determine HIV-1/2 Ag/Ab Combo test in Zambia.

The researchers found that they could consistently detect Kaposi Sarcoma-associated herpes viral DNA in tumors, but variably in plasma and peripheral blood mononuclear cells of participants with Kaposi Sarcoma.

The results indicated that, consistent with elevated antibody-associated cytokines (IL-6, IL-5, and IL-10), total and Kaposi Sarcoma-associated herpes virus-neutralizing antibody titers were higher in participants with epidemic-KS and endemic-Kaposi Sarcoma compared with in control patients (P <.05). Even with HIV-1 coinfection in participants with epidemic- Kaposi Sarcoma, the researchers found that total and Kaposi Sarcoma-associated herpes virus-neutralizing antibody titers were similar between patients with epidemic-Kaposi Sarcoma and those with endemic- Kaposi Sarcoma (P =.3).

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“Longitudinal analyses of the current cohort as they undergo [Kaposi Sarcoma] and HIV-1 specific treatment will help to illuminate additional potential immune markers of treatment response and long-term control,” the researchers concluded.


Lidenge SJ, Tso FY, Ngalamika O, et al. Similar immunological profiles between African endemic and HIV1-associated epidemic Kaposi’s sarcoma patients reveal the primary role of KSHV in KS pathogenesis [published online November 19, 2018]. J Infect Dis. doi: 10.1093/infdis/jiy654