HHV-8-associated diseases in transplantation: A case report and narrative review focused on diagnosis and prevention

Transpl Infect Dis. 2024 Nov:26 Suppl 1:e14334. doi: 10.1111/tid.14334. Epub 2024 Jul 7.

Abstract

Background: Human herpes virus 8 (HHV-8) or Kaposi sarcoma herpesvirus (KSHV) is an opportunistic oncovirus that causes multiple pathologic entities.

Methods: We present a case of fatal HHV-8-associated multisystem illness with disseminated Kaposi sarcoma and HHV8-associated lymphoproliferative disorder with systemic inflammation. We conducted a narrative review of the literature on HHV-8 in transplantation with a goal of illuminating the spectrum of HHV-8-associated diseases in this vulnerable population, modes of disease transmission, and the potential role for donor and recipient screening.

Results: HHV-8-associated KS, primary effusion lymphoma (PEL), multicentric Castleman disease (MCD), and KSHV inflammatory cytokine disorder (KICS) may affect transplant recipients; with the exception of KS, these conditions are rare but carry high morbidity and mortality.

Conclusion: HHV-8-associated diseases have diverse and protean manifestations in transplant recipients, with potentially fatal outcomes. HHV-8 seroprevalence among organ donors and the magnitude of risk for donor-derived HHV-8 infection or clinically significant disease remain unknown and require further study.

Keywords: Kaposi sarcoma; donor‐derived infections; human herpesvirus 8; liver transplant; lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Castleman Disease / diagnosis
  • Castleman Disease / virology
  • Fatal Outcome
  • Female
  • Herpesviridae Infections / diagnosis
  • Herpesvirus 8, Human* / immunology
  • Herpesvirus 8, Human* / isolation & purification
  • Humans
  • Lymphoma, Primary Effusion / diagnosis
  • Lymphoma, Primary Effusion / virology
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / virology
  • Male
  • Middle Aged
  • Sarcoma, Kaposi* / diagnosis
  • Sarcoma, Kaposi* / virology

Supplementary concepts

  • Multi-centric Castleman's Disease