Elsevier

Microbial Pathogenesis

Volume 111, October 2017, Pages 431-434
Microbial Pathogenesis

Presence of human herpesvirus 8 (HHV-8) DNA sequences in patients with lymphoproliferative diseases and chronic blood disorders

https://doi.org/10.1016/j.micpath.2017.09.014Get rights and content

Highlights

  • Viral infections may be associated with lymphoproliferative diseases.

  • Human herpesvirus 8 (HHV-8) is the causative agent of Kaposi's sarcoma (KS) which can be associate with different hematologic malignancies.

  • HHV-8 was investigated to understand the etiology of lymphoproliferative diseases.

  • In this study, there was no significant association between lymphoproliferative diseases and Human herpesvirus 8.

Abstract

Objective

Human herpesvirus 8 (HHV-8) is the causative agent of Kaposi's sarcoma (KS), but it has also been associated with different hematologic malignancies, including plasmablastic lymphoma, Multicentric Castleman's disease (MCD), primary effusion lymphoma (PEL) and various atypical lymphoproliferative disorders. Patients with underlying lymphoproliferative diseases and chronic blood disorders who become infected with this virus are at risk for human malignancies. This small study reported the frequency of human herpesvirus 8 in 81 Iranian patients with lymphoproliferative disorders for estimation of possible factors affecting malignancy.

Methods

The laboratory records of 81 patients' peripheral blood mononuclear cell (PBMC)samples, which were tested for detection of HHV-8 open reading frame (ORF) 26 DNA by nested PCR amplification during the period from Sept. 2014 to Sept. 2015, were reviewed retrospectively at the Firouzgar Hospital, Tehran, Iran.

Results

Of 81 subjects, 28 were non-Hodgkin's lymphoma (NHL), 19 were Hodgkin's lymphoma (HL), 20 were acute lymphoblastic leukaemia (ALL), 11 were chronic lymphocytic leukaemia (CLL) and 2 were multiple myeloma (MM). HHV-8 was detected in 16 (19.8%) of the 81 patients. Five out of the sixteen positive patients had CLL followed by 4 NHL, 4 HL and 3ALL.

Conclusion

We conclude that HHV-8 can be considered as one of the predisposing factors of malignancy in patients with lymphoproliferative and chronic blood disorders. Furthermore, it does not rule out the possibility that other immunological triggers and environmental risk factors may account for their etiopathogenesis.

Introduction

Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma (KS)-associated herpesvirus (KSHV), is a gamma herpesvirus. Described in 1994 by Chang et al., it was first identified from patients with AIDS and Kaposi's sarcoma and then its correlation with distinct lymphoproliferative disorders, MulticentricCastleman's disease (MCD), primary effusion lymphoma (PEL), solid lymphomas with anaplastic/immunoblastic morphology and its related plasmablastic lymphoma were investigated exclusively [1], [2], [3].

KSHV/HHV-8 prevalence is organized into three groups based on incidence: high (>50%) in sub-Saharan Africa and parts of the Amazon basin, intermediate (between 5% and 20%) in the Mediterranean, Middle East and Caribbean and low (up to 5%) in Northern and Western Europe and in the United States [4], [5].

Oncogenic transformation and immunological disturbances of the KSHV genome are based on some cofactors such as viral oncogenes, immune system status and cytokine regulation. However, the prognosis of KSHV-related lymphoma is poor and its oncogenic mechanisms are not clearly elucidated [6], [7].

Although patients with lymphoma, leukaemia, autoimmune cytopenia and myeloproliferative disorders had higher association with HHV-8 serologically, investigations on HHV-8 DNA in peripheral blood mononuclear cells (PBMCs) are rare [7], [8]. Whereas there are some similar features in MCD and HL patients especially by their lymphoma due to lymphoid proliferations, they could have correlation with same agent such KSHV [9], [10].

In this regard, this study aimed to investigate HHV-8 infection for the first time in patients from Iran with lymphoproliferative diseases and chronic blood disorders, including CLL, ALL, NHL, HL and MM.

Section snippets

Patient selection

This cross sectional study was conducted by hospitals affiliated with the Iran University of Medical Sciences. Practitioners diagnosed patients by clinical manifestations and laboratory findings.The inclusion criteria were: positive diagnosis of a lymphoproliferative disorder (established on clinical evaluation included lymph node biopsy and flowcytometry on peripheral blood, bone marrow aspirate, and so on) and infection with human herpesvirus −8. The exclusion criterion was the absence of

Results

The characteristics of a total of 81 patients in five groups, non-Hodgkin's lymphoma (NHL) (28 subjects), Hodgkin's lymphoma (HL) (19 subjects), acute lymphoblastic leukaemia (ALL) (20 subjects), chronic lymphocytic leukaemia (CLL) (11 subjects) and multiple myeloma (MM) (2 subjects), are shown in Table 1.

Based on the PCR results (Fig. 1), we found that 16 of 81 (19.8%) participants were infected with KSHV DNA. By the separate groups, 4 (14.3%) were NHL, 4 (21.1%) were HL, 3 (15%) were ALL and

Discussion

The pathogenesis of lymphoproliferative disorders was widely surveyed for discussible roles the viruses played in antecedent the development of malignant symptoms. In the present study, patients with lymphoproliferative diseases and chronic blood disorders were analysed for HHV8/KSHV-associated infection in Iran. Among 81 patients in five groups, HL, NHL, ALL, CLL and MM, we found that there were 4 (21.1%), 4 (14.3%), 3 (15%), 5 (45.5%) and 0 infected individuals, respectively, in each group (p

Acknowledgment

The authors acknowledge the patients for participation in this project. This work was supported by Iran University of Medical Sciences (IUMS) with Grant no. 24799.

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