Elevated seroprevalence of human herpesvirus 8 among men with prostate cancer

Background. To investigate any epidemiological association between human herpesvirus (HHV)-8 and prostate cancer, we determined the prevalence of HHV-8 seropositivity among prostate cancer case and control subjects in the United States and Trinidad and Tobago.Methods. Antibodies against HHV-8 were detected in 2 independent laboratories using either indirect immunofluorescence assay (IFA) or a combination of enzyme-linked immunosorbent assay and IFA.Results. Among 138 Tobago men with prostate cancer, HHV-8 seroprevalence was 39.9%-significantly higher than that among 140 age-matched control subjects (22.9%; P=.003; odds ratio [OR], 2.24; 95% confidence interval [CI], 1.29-3.90). Among 100 US men with prostate cancer, seroprevalence was 20%-significantly higher than that of 177 blood donors (5.1%; P=.001; OR, 4.67; 95% CI, 1.91-11.65) and higher than that of 99 men with cancer not related to HHV-8 (13%; P=.253; 95% CI, 0.77-3.54).Conclusions. HHV-8 seropositivity is elevated among men with prostate cancer compared with control subjects, which suggests that HHV-8 plays a role in the development of prostate cancer.     

The seroprevalence of human herpesvirus 8 infection in the Thai population

The seroprevalence of human herpesvirus 8 (HHV-8) infection in the Thai population was investigated. Sera from 1,018 human immunodeficiency virus 1 (HIV-1)-negative and 436 HIV-1-positive individuals were tested for antibodies to latent and lytic HHV-8 antigens by indirect immunofluorescence assay (IFA) and an enzyme-linked immunosorbent assay (ELISA) using mixed recombinant orf HHV-8 proteins. The positive sera were further tested with recombinant HHV-8 protein expressed 293T cells by IFA. The seroprevalence of HHV-8 infection was determined by the concordant reactivity of sera among antibody testing assays. The results showed a low rate of HHV-8 seropositivity in both HIV-1-negative healthy individuals (0.6%) and HIV-1-infected patients (0.7%). These results are consistent with the fact that a small number of patients with AIDS-associated KS have been reported in Thailand and that HHV-8 is an uncommon pathogen in this country. Interestingly, we found that sera from the general population living in the north, but not other regions of Thailand, had antibodies to HHV-8.     

Human herpesvirus 8 seroprevalence among prostate cancer case patients and control subjects

To investigate a possible association between human herpesvirus 8 (HHV-8) and prostate cancer, we evaluated HHV-8 seroprevalence in 2 case-control studies. HHV-8 antibodies were detected by immunofluorescence with cells expressing lytic viral proteins and by enzyme immunoassays with recombinant viral structural protein (K8.1) and latent protein (latency-associated nuclear antigen-1; open reading frame 73), respectively. HHV-8 seroprevalence tended to be lower in patients with prostate cancer than in control subjects, but there was no significant difference in either study. These data imply that HHV-8 is not a major prevalent cause of prostate cancer.     

Detection of human herpesvirus 8 in cervicovaginal secretions and seroprevalence in human immunodeficiency virus type 1-seropositive and -seronegative women

Epidemiologic studies suggest that human herpesvirus 8 (HHV-8) may be sexually transmitted. To study the potential for HHV-8 transmission through cervicovaginal (CV) secretions, the presence of HHV-8 DNA was investigated by nested polymerase chain reaction in the cellular fraction of CV secretions from 36 human immunodeficiency virus type 1 (HIV-1)-seropositive and 29 HIV-1-seronegative women. The same patients were tested for antibodies to two defined HHV-8 antigens (latency-associated nuclear antigen and open-reading frame 65-encoded structural protein) and for HHV-8 DNA in their peripheral blood mononuclear cells (PBMC). The findings were compared with the rate of HHV-8 detection in semen samples of 20 HIV-1-infected men. HHV-8 DNA was detected in the CV samples from only 1 HHV-8-seropositive AIDS patient, in 3 PBMC samples (1/29 HIV-1-seronegative patients, 1/3 AIDS patients with Kaposi's sarcoma, and 1/19 AIDS patients), and in 1 of 20 semen samples. HHV-8 infection was more common in HIV-1-infected than uninfected women. Thus HHV-8 DNA is only rarely detectable in CV secretions and semen of HHV-8-infected individuals.     

Human herpesvirus 8: seroprevalence and correlates in prostitutes in Mombasa,Kenya

Human herpesvirus 8 (HHV-8) infection is very prevalent in sub-Saharan Africa, but the role of sexual transmission has not been well characterized. HHV-8 seroprevalence and correlates were evaluated in a cohort of female prostitutes in Mombasa, Kenya. Between February 1993 and January 2000, stored plasma samples taken from 736 women were tested, by whole-virus ELISA assay, for the presence of HHV-8 antibodies; of these 736 women, 633 were included in the analysis of correlates of HHV-8 infection; and, of these 633, 44.1% were seropositive for HHV-8 antibodies. In univariate analysis, age, years of education, years of prostitution, workplace, hormonal contraception, intrauterine-device use, alcohol consumption, syphilis, and gonorrhea were all significantly associated with the presence of HHV-8 antibodies. In a multivariate model, older age, fewer years of education, and 2 markers of high-risk sexual behavior-namely, alcohol consumption and gonorrhea-were each independently associated with HHV-8 seropositivity. These results suggest that heterosexual transmission may contribute to acquisition of HHV-8 infections in this African population of prostitutes.     

Pulmonary hypertension in patients with hematological disorders following splenectomy

Prevalence of pulmonary arterial hypertension (PAH) was studied by Echocardiography and Doppler in 43 splenectomised patients with various disorders 1–20 years after splenectomy. PAH was detected only in thalassemia major, intermedia, hereditary sphereocytosis and myelofibrosis groups comprising a total of 21 patients. Six patients out of 21 was found to have PAH with mean pulmonary arterial pressure of 46.28 ± 28.17 mmHg. Twenty one controls having similar duration and type of disease also were assessed for PAH in this case control study 3/21 had PAH in this control group. The difference in number of patients showing pulmonary hypertension between case and control was not statistically significant (chi-square test p = 0.29-though the difference in pulmonary arterial pressure between case and control were significantly different (t-test p<0.0029) with control group showing a mean pulmonary arterial pressure of 25 ± 19 mmHg. Platelet count in the splenectomised group was significantly higher (p = 0.0029) than the controls. Pulmonary thromboembolism was equally high in the PAH patients with and without splenectomy. Patients undergoing splenectomy due to trauma, immune thrombocytopenia, sideroblastic anemia, extra hepatic portal hypertension, autoimmune hemolytic anemia did not show PAH after splenectomy even years after the procedure PAH following splenectomy is common after certain disorders and control patients with these diseases have tendency to develop PAH even without splenectomy. Pulmonary thromboembolism may be an important pathophysiological mechanism leading to this condition. Patients having hemolytic anemia and myelofibrosis should have regular evaluation of pulmonary arterial pressure whether he/she has been splenectomised or not. This is particularly important as availability of phosphodiesterase inhibitors like sildenafil allows one to manage these cases.     

Pulmonary hypertension in patients with hematological disorders following splenectomy

Prevalence of pulmonary arterial hypertension (PAH) was studied by echocardiography and Doppler in 43 splenectomized patients with various disorders 1–20 years after splenectomy. Pulmonary arterial hypertension was detected only in thalassemia major, intermedia, hereditary sphereocytosis and myelofibrosis groups comprising a total of 21 patients. Six patients out of 21 was found to have PAH with mean pulmonary arterial pressure of 46.28 ± 28.17 mm of Hg. Twenty-one controls having similar duration and type of disease also were assessed for PAH in this case control study 3/21 had pulmonary arterial hypertension in this control group. The difference in number of patients showing pulmonary hypertension between case and control was not statistically significant (Chi square test P=0.29) though the difference in pulmonary arterial pressure between case and control were significantly different (t test P<0.0029) with control group showing a mean pulmonary arterial pressure of 25 ± 19 mm Hg. Platelet count in the splenectomized group was significantly higher (P=0.0029) than the controls. Pulmonary thromboembolism was equally high in the PAH patients with and without splenectomy. Patients undergoing splenectomy due to trauma, immune thrombocytopenia, sideroblastic anemia, extrahepatic portal hypertension, autoimmune hemolytic anemia did not show PAH after splenectomy even years after the procedure PAH following splenectomy is common after certain disorders and control patients in these diseases have tendency to develop PAH even without splenectomy. Pulmonary thromboembolism may be an important pathophysiological mechanism leading to this condition. Patients having hemolytic anemia and myelofibrosis should have regular evaluation of pulmonary arterial pressure whether he/she has been splenectomized or not. This is particularly important as availability of phosphodiesterase inhibitors such as sildenafil allows one to manage these cases.     

Danish patients with untreated multiple myeloma do not harbour human herpesvirus 8

The role of human herpesvirus 8 (HHV-8) in multiple myeloma (MM) remains controversial. We examined 15 Danish MM patients before cytoreductive therapy. Mononuclear cells isolated from peripheral blood and bone marrow aspirates, as well as long-term cultured bone marrow stromal cells, were assayed for the presence of HHV-8 DNA. All material was tested by three simple unnested polymerase chain reaction (PCR) assays (amplifying regions of ORF26, ORFK1 and ORF75) and two nested PCR assays (amplifying regions of ORF26). HHV-8 was not demonstrated in any of the samples. Our findings do not suggest an association between HHV-8 and MM in the Danish population.     

Treatment type and amount influenced human immunodeficiency virus seroprevalence of patients with congenital bleeding disorders

Two hundred and eighty-two patients with congenital bleeding disorders received blood component replacement therapy between January 1979 and April 1985, were followed-up by the Puget Sound Blood Center's Hemophilia Care Program, and were tested for antibody to human immunodeficiency virus (HIV). Serologic results were obtained at least 1 year after the last exposure to volunteer donor products that were prepared before donor HIV screening or after the last exposure to concentrates produced before the manufacturer's use of treatment methods for inactivation of HIV. In all, 106 patients were anti-HIV positive. The risk of HIV infection was greater in patients with more severe bleeding tendencies, greater exposure to components, and exposure to lyophilized concentrates from large pools of donors. Of 100 patients with hemophilia A who only received cryoprecipitate from volunteer donors from Washington State (during the 6.3-year period), 14% had become anti-HIV positive. Of 27 patients receiving mostly cryoprecipitate but also being exposed to a single lot of concentrate during the same period, 13 (48%) were positive. Of 49 patients treated predominantly or solely with factor VIII concentrates during this period, 43 (88%) were anti-HIV positive. Of 29 patients with von Willebrand disease, four were anti-HIV positive, including 2 of 26 receiving only cryoprecipitate and two of three who had received a single dose of factor VIII concentrate. Of 19 patients who were treated solely with volunteer donor plasma, all remained anti-HIV negative. Of 47 patients exposed to factor IX concentrate, 28 (60%) were positive. Data relevant to the risk of HIV transmission subsequent to screening of the volunteer donor population were also obtained. Treatment records of 55 hemophilia A patients who have remained anti-HIV negative through at least June 1990 showed exposure to 71,173 screened donors from May 1985 through December 1989, and all 55 patients have remained anti-HIV negative.     

Tropism of human herpesvirus 8 for peripheral blood lymphocytes in patients with Castleman's disease

Multicentric Castleman's disease (MCD), also called multicentric angiofollicular lymphoid hyperplasia, is a systemic lymphoproliferative disorder causing fever, lymphadenopathy and splenomegaly. Recently, Kaposi's sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV-8) DNA sequences have been detected in cases of MCD. We examined HHV-8 DNA sequences in the peripheral blood mononuclear cells (PBMCs) of two HIV-negative patients with MCD and in PBMCs and the lymph node of a HIV-negative patient with localized Castleman's disease (LCD) by the polymerase chain reaction. The novel sequences were detected in all DNA samples. Furthermore, the sequences were detected in only the CD19⁺ B-lymphocyte fraction of the patient with LCD as previously reported. However, the sequences were detected in CD19⁺ B-lymphocyte and CD2⁺ T-lymphocyte fractions of two patients with MCD. These results suggest that HHV-8 has tropisms for both B lymphocytes and T lymphocytes in Castleman's disease.     

Lack of human herpesvirus 8 infection in lungs of Japanese patients with primary pulmonary hypertension

Samples of lung tissue, taken at autopsy, from 10 Japanese patients with primary pulmonary hypertension (PPH) and samples of lung tissue from 12 Japanese patients with secondary pulmonary hypertension were tested for the presence of human herpesvirus 8 (HHV-8). All samples from patients with PPH contained plexiform lesions around pulmonary arterial vessels, but immunohistochemistry failed to detect the HHV-8-encoded latency-associated nuclear antigen. HHV-8 DNA could not be amplified by polymerase chain reaction for the HHV-8-encoded K1 and KS330(233) genes in any sample. These data suggest that HHV-8 infection is not associated with PPH in Japanese patients.     

恶性血液病医院感染分析

对我院2000年12月～2001年11月血液科住院病人中发生医院感染的81例患者进行回顾性统计分析。结果发现：恶性血液病医院感染率明显高于普通疾病，尤其是髓系细胞恶性血液病；感染好发部位为呼吸道、血液、口腔、消化道等，病原菌以G-杆菌为主，原发病性质及化疗是医院感染率明显增高的主要因素。认为对于恶性血液病患者采取预防措施，提高机体免疫力，早期给予积极的干预，可以减少或减轻医院感染。