Center for Medical Ethics and Health Policy Staff Publications
Publication Date
11-22-2023
Journal
JCI Insight
DOI
10.1172/jci.insight.167854
PMID
37991023
PMCID
PMC10721314
PubMedCentral® Posted Date
11-22-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
United States, Humans, Child, Adult, Sarcoma, Kaposi, Herpesvirus 8, Human, Cross-Sectional Studies, Virus Replication, HIV Infections, AIDS/HIV, Oncology, Cancer, Kaposi sarcoma
Abstract
BACKGROUND
Kaposi sarcoma (KS) is among the most common childhood cancers in Eastern and Central Africa. Pediatric KS has a distinctive clinical presentation compared with adult KS, which includes a tendency for primary lymph node involvement, a considerable proportion of patients lacking cutaneous lesions, and a potential for fulminant disease. The molecular mechanisms or correlates for these disease features are unknown.
METHODS
This was a cross-sectional study. All cases were confirmed by IHC for KS-associated herpesvirus (KSHV) LANA protein. Baseline blood samples were profiled for HIV and KSHV genome copy numbers by qPCR and secreted cytokines by ELISA. Biopsies were characterized for viral and human transcription, and KSHV genomes were determined when possible.
RESULTS
Seventy participants with pediatric KS were enrolled between June 2013 and August 2019 in Malawi and compared with adult patients with KS. They exhibited high KSHV genome copy numbers and IL-6/IL-10 levels. Four biopsies (16%) had a viral transcription pattern consistent with lytic viral replication.
CONCLUSION
The unique features of pediatric KS may contribute to the specific clinical manifestations and may direct future treatment options.
FUNDING
US National Institutes of Health U54-CA-254569, PO1-CA019014, U54-CA254564, RO1-CA23958.
Included in
Bioethics and Medical Ethics Commons, Biological Phenomena, Cell Phenomena, and Immunity Commons, Health Policy Commons, Medical Immunology Commons, Oncology Commons