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HHV-8/ Kaposi's Sarcoma - Patient Information What is Kaposi's sarcoma?
Kaposi's sarcoma (KS) is a cancer like disease. It usually shows up in the skin, or in the liningsof the mouth, nose or eye. KS can also spread to the lungs, stomach, and intestines. The cancer is caused by a virus known as Human herpesvirus-8 (HHV-8). This is a rare virus, affecting between 5-25% of the world's population. The virus is most common in Africa and Mediterranean countries such as Italy and Greece. If a person's immune response isn't working properly, (e.g. AIDS and transplant patients), and they are infected with HHV-8 then they have a high risk of developing KS. It is mostly a disease of men - it effects about 8 men for every woman. The reason for this is not known but it is thought that the virus or another cofactor may be more effectively transmitted via anal intercourse. This would also explain the disproportion between infection in homosexual and heterosexual men. What are the symptoms of KS? - Blueish-red lesion with an irregular shape.
- Bleeding with gastrointestinal lesions.
- Shortness of breath with pulmonary lesions.
The lesions are usually flat, painless and do not itch or drain. As the KS lesion grows, they can become raised bumps or patches and grow together. Because KS can appear anywhere on the body, and may look like other skin lesions, a biopsy is usually required to confirm diagnosis. A biopsy is when your doctor takes a small sample from new skin spots and examines it under a microscope. How is KS Treated?
Treatment decisions depend upon the extent and location of the lesion, as well as the patients symptoms and degree of immune damage. KS on the skin does not have to be treated if there are only a few lesions. Skin lesions can be surgically removed or treated with radiation. Can KS be Prevented?
One of the best ways to prevent the development of Kaposi's sarcoma is to be tested for HHV-8. Studies have shown that if you have the virus while your immune system is low then you are very likely to develop KS. If you are positive for the virus you can then be treated with antiviral drugs such as foscarnet and ganciclovir.
What are the complications of HHV-8 in AIDS patients?
HHV-8 is a virus and the causative agent of a cancer-like illness called Kaposi's sarcoma. Kaposi's sarcoma affects about 20% of people with AIDS and causes a significant number of deaths in these patients. KS is one of the most visible signs of AIDS, because it usually shows up as spots on the skin that look red / purple on dark skin. In AIDS patients the virus can develop aggressivelyand spread to other organs. Early lesions may start on the feet or ankles and spread to the arms and hands. How can I prevent development of KS if I am HIV positive?
The best prevention is to reinforce the more general safe sex practices that have been promoted to prevent HIV and other sexually transmitted diseases. If you are HIV positive it may also be a good idea to ask your doctor about getting tested regularly for HHV-8. If you become positive for HHV-8 after you acquire HIV then you have the highest risk of developing KS. This is because your immune system will not be working properly due to the HIV infection. What are the complications of HHV-8 in Transplantation?
The incidence of Kaposi's sarcoma after transplantation, in particular kidney transplantation, is 0.5 - 5%.
The main risk factors are: - If the recipient is infected with HHV-8 before transplantation, then there is a very high probability that he/she will develop KS after the transplant.
- If the organ donor is infected with HHV-8, then the virus may be carried in the organ and passed on to the recipient during transplantation.
- Geographical location: if you live in Africa or Mediterranean areas then you have a higher risk of becoming infected with HHV-8. HHV-8 can be treated with the antiviral drugs ganciclovir and foscarnet.Screening of transplant donors and recipients for HHV-8 is not yet routine, howeverif you are concerned about infection you should ask your doctor about getting tested prior to the transplant, especially if you think you have a high risk.
Links of Interest: Medline Plus:
http://www.nlm.nih.gov/medlineplus/kaposissarcoma.html The Body - An AIDS/HIV information portal:
http://www.thebody.com/treat/kaposis.html American Cancer Society:
http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_kaposis_sarcoma_21.asp?sitearea=cri Cancer Backup:
http://www.cancerbacup.org.uk/Cancertype/Kaposissarcoma AIDS map information portal:
http://www.aidsmap.com/en/docs/4AEE5465-82A9-4E7E-B385-D215829FF30A.asp The National Cancer Institute:
http://www.nci.nih.gov/cancerinfo/pdq/treatment/kaposis/patient/
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