Correlates of Human Herpesvirus-8 DNA detection among adults in Italy without Kaposi sarcoma

BACKGROUND: The presence of Human Herpesvirus-8 (HHV8) DNA is predictive of Kaposi sarcoma (KS) among patients with HIV-associated or iatrogenic immunosuppression. However, correlates of HHV8-DNA detection in the general population remain undefined. METHODS: We assessed correlates of HHV8-DNA detection among Italian adults without KS who had antibodies against HHV8-latent nuclear antigen by immunofluorescence assay. HHV8-K6 DNA sequences were detected in peripheral blood mononuclear cells using TaqMan PCR. RESULTS: Of the 158 subjects 26 (16.5%) had detectable HHV8-DNA [median copies/million cells, 53; (13-2128)]. Adjusted for age, sex, and laboratory, HHV8-DNA was detected more frequently in participants with >7 total residents in the childhood home [OR = 3.7 (1.5-9.1)], >2 younger siblings [OR = 2.6 (1.1-6.5)], and current cardiovascular [OR = 3.6 (1.3-9.7)] or renal [OR = 3.1 (1.2-8.0)] disease. Excluding the participants using immune modulating drugs, HHV8-DNA was more frequent among those with low red blood cells (RBC) [<4.5 10(6)/microl; OR = 5.3 (1.7-16.2)], slightly elevated mean corpuscular volume [>92 microm3/red cell; OR = 2.8 (1.0-7.8)], and mild thrombocytopenia [<151 K/microl; OR = 5.6 (1.9-16.3)]. CONCLUSIONS: Presence of HHV8-DNA in elderly Italians is associated with childhood crowding, low RBCs, and platelets, perhaps indicating roles for early infection and chronic inflammation. These risk factors are the first to be reported for non-immunosuppressed HHV8-seropositive adults.     

Hodge and his planes

Hugh Lenox Hodge (1796-1873) was professor of obstetrics at the University of Pennsylvania for more than 25 years. He divided the birth canal into four virtual and parallel planes through pelvic protuberances, a method still widely used. He also developed a pessary that is now mainly used in stress incontinence.     

Snellen and his optotypes

Herman Snellen (1834-1908) studied medicine in Utrecht and wrote a thesis under the guidance of Franciscus Donders (1818-1889). In 1858 he became assistant and a few years later first physician at Donders' newly-founded eye hospital. In 1862 he published his optotypes, letters of different sizes, constructed in squares with 5 x 5 subdivisions. For each row of letters of a given size there is an indication of the distance D at which a normal eye can just distinguish these (corresponding with 5 minutes of arc). If the eye of the subject being examined can just make out letters of a given size at distance d, the visual acuity V for that eye is d/D. Snellen was a gifted surgeon for a variety of ophthalmologic disorders. In 1877 he was appointed Professor of Ophthalmology at Utrecht and in 1884 he succeeded Donders as director of the eye hospital.     

Willis and his circle

Thomas Willis (1621-1675) grew up in Wiltshire and studied medicine in Oxford, at a time when the city was besieged and then occupied by Parliamentarian troops. He started his career as a country doctor while concurrently taking part in informal gatherings with other scientists (William Petty, Christopher Wren and, later on, Robert Hooke, Richard Lower and Robert Boyle). They performed physical and chemical experiments and carried out a variety of tests on animals. After the restoration of the monarchy in 1660 Willis combined his practice with academic teaching. From then on he focused his studies on the structure and function of the brain, dissecting brains after removal from the skull and fixation in 'spirit of wine'. In his 'Cerebri anatome' of 1664, illustrated by Wren, he drew attention to the arterial circle at the base of the brain, including its physiological advantages. This arterial circle had been incompletely described by others in the past and fully, but only in writing, by Wepfer in 1658.     

Wenckebach and his rhythm

Karel Frederik Wenckebach (1864-1940) showed an aptitude for research even as a medical student in Utrecht. After graduation and a thesis on the bursa of Fabricius he worked as an assistant in the physiological laboratory. Following a stint as general practitioner in a mining community (1891-1896) he returned to Utrecht, where he could combine his practice with physiological studies, especially disturbances of the heart rhythm. In 1899, with no other recording instruments than a sphygmomanometer for tracing the radial pulse and a tuning fork for chronometry, he described the 'rhythmic arrhythmia' phenomenon: a missed beat after a given number of regular beats (mostly between three and six), followed by an intermission shorter than the interval between two regular beats. The Wenckebach rhythm is now also known as type I second-degree atrioventricular block. Wenckebach subsequently became a professor of medicine in Groningen (1901), Strasbourg (1911) and Vienna (1914-1929).