HHV-8 Flashcards
What is the site of HHV-8 latency?
B lymphocytes (like EBV)
What is the viral marker of latently infected HHV-8 cells? (Hint this is a homolog of EBNA)
LANA (latency associated nuclear antigen 1)
Transmission routes of HHV-8
Mainly saliva and semen
Also IVDU, flagellation, organ transplant
Name the diseases associated with HHV-8
Kaposi’s sarcoma (classic, endemic, epidemic, iatrogenic)
KS inflammatory cytokine syndrome (KICS)
Multi centric Castlemans disease (MCD)
Primary effusion lymphoma (PEL)
Diffuse B large cell lymphoma (KDLBCL)
Germinotropic lymphoproliferative disease (GLD)
What is multi centric Castlemans disease? What are the symptoms? What % have HHV-8? Is PCR useful? Treatment
B cell lyphoproliferative disease
B symptoms, hepatosplenomegally, respiratory dysfunction. In severe cases may resemble sepsis. Symptoms can be secondary to excess release of IL6
50% HHV-8 positive
Patients have high plasma load which can be used for monitoring progression
Rituximab. Reduction of immunosuppression/ART. +/- chemo and antivirals
What is primary effusion lymphoma? What are the symptoms? What % have HHV-8? Is PCR useful? Treatment
B cell non-Hodgkin lymphoma (liquid lymphoma)
Shortness of breath. Pleural/pericardial/peritoneal effusion
100% HHV-8 positive and high % co infected with EBV
PCR can be useful for monitoring progression
Reduction of immunosuppression, CHOP, antivirals
What is KS inflammatory cytokine syndrome? What are the symptoms? What % have HHV-8? Is PCR useful? Treatment
Like MCD but with no pathological changes
Can present like sepsis with respiratory distress due to high levels of IL6
In HHV-8 and HIV confection
High viral load 
Rituximab to decrease IL6
What are the diagnostics tests are available for HHV-8?
Serology - few assays available and send/spec poor. So only performed at one centralised lab
Quantitative PCR in blood
Biopsy can have PCR or IHC for LANA. Spindle-like cells seen in KS lesions
ELISPOT can be used to monitor T cell response
What antivirals are active against HHV-8?
Ganciclovir
Foscarnet
Cidofovir
What is the risk of HHV-8 transmission from a positive organ donor?
50%
