Human herpesvirus 8 infection among various population groups in southern Israel.

OBJECTIVE: To compare the prevalence of antibodies to human herpesvirus 8 (HHV-8) or Kaposi sarcoma-associated herpesvirus among Israeli and Ethiopian subjects. METHODS: Serum samples were obtained from 98 Israeli Jewish students aged 18-30 years, 100 HIV-1-seronegative Ethiopian immigrants to Israel of the same age, and 100 HIV-1-seronegative Ethiopian children 1-12 years old upon their arrival in southern Israel. Plasma samples were obtained from 3 hospitalized patients with multicentric Castleman disease (MCD) as positive controls. All serum samples were tested for antibodies to both latent and lytic antigens. Antibodies to the lytic antigens and the latency-associated nuclear antigen (LANA) of HHV-8 were detected by enzyme linked immunosorbent assay and by immunofluorescence assay. HHV-8 DNA from serum or plasma samples was detected by polymerase chain reaction analysis. RESULTS: Antibodies to HHV-8 LANA were detected in 2.9% of the Israeli subjects aged 18-30 years and in 26% of the Ethiopian subjects from both age groups tested. Antibodies to the lytic antigens were detected in all 3 MCD patients, in 4% of the Ethiopian children, and in 2% of the 18- to 30-year-old Ethiopians. No antibodies to the lytic antigens were detected in the Israeli students. HHV-8 DNA was detected in all 3 MCD patients and in 2 of 4 of the Ethiopian children positive for the lytic antigens. CONCLUSIONS: HHV-8 is highly prevalent in Ethiopian immigrants to Israel as compared with Israeli students. Antibodies to HHV-8 in Ethiopia are acquired before puberty. The results of this study indicate the association of HHV-8 with MCD, as has been documented by many other researchers.

Spectrum of Kaposi's sarcoma-associated herpesvirus, or human herpesvirus 8, diseases.

Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), discovered in 1994, is a human rhadinovirus (gamma-2 herpesvirus). Unlike other human herpesviruses (herpes simplex virus, Epstein-Barr virus, varicella-zoster virus, cytomegalovirus, HHV-6, and HHV-7), it is not widespread in the general population and has many unique proteins. HHV-8 is strongly associated with all subtypes of Kaposi's sarcoma (KS), multicentric Castleman's disease, and a rare form of B-cell lymphoma, primary effusion lymphoma. In addition, HHV-8 DNA sequences have been found in association with other diseases, but the role of the virus in these diseases is largely unconfirmed and remains controversial. The seroprevalence of HHV-8, based on detection of latent and lytic proteins, is 2 to 5% in healthy donors except in certain geographic areas where the virus is endemic, 80 to 95% in classic KS patients, and 40 to 50% in HIV-1 patients without KS. This virus can be transmitted both sexually and through body fluids (e.g., saliva and blood). HHV-8 is a transforming virus, as evidenced by its presence in human malignancies, by the in vitro transforming properties of several of its viral genes, and by its ability to transform some primary cells in culture. It is not, however, sufficient for transformation, and other cofactors such as immunosuppressive cytokines are involved in the development of HHV-8-associated malignancies. In this article, we review the biology, molecular virology, epidemiology, transmission, detection methods, pathogenesis, and antiviral therapy of this newly discovered human herpesvirus.

Chronic fatigue syndrome (CFS): Review of clinical data from 107 cases

Se estudiaron 107 pacientes con SFC de entre 7 y 76 años de edad (promedio 41.8 años). 67 fueron del sexo femenino y 47 del masculino (relación F/M 1.27L1). Los períodos de seguimiento duraron desde 10 meses hasta 7.5 años. Los pacientes fueron reclutados mediante un cuesitonario (anexo) adecuando los criterios de Holmes para SFC, se realizó además examen clínico, biometría hemática, química sanguínea, fenotipificación de linfocitos y control de otros parámetros inmunológicos, así como estudios para detección de infecciones. En un paciente se diagnosticó síndrome miálgico-eosinofílico, 6 pacientes presentaron deficiencia de vitamina D3 (25-OH), cuyos síntomas se revirtieron con tratamiento de reposición. De los 100 pacientes restantes, 4 habían tenido episodios psiquiátricos previos. En 67 por ciento de los pacientes con SFC se comprobó infección persistente o recurrente, otro 16 por ciento sugería infección. La infección activa detectada con más frecuencia fue por virus herpes humano-6 (HHV-6) en 38.6 por ciento de los casos, seguida por infección por virus de Epstein-Barr (VEB) en 19.6 por ciento, menos frecuente fue la detección de virus herpes simple (VHS), chlamydia, campylobacter, coxsackie, citomegalovirus (CMV), yersinia o cándida. En el 46 por ciento de los pacientes se encontraron signos de inmunodeficiencia, mientras que en un 20 por ciento adicional la evidencia fue menos clara, consistiendo por ejemplo en disminución de la estimulación linfocitaria (46 por ciento), baja cantidad de células asesinas naturales (NK) (35 por ciento) y relación de células CD4/CD8 disminuída (21 por ciento). Del 14 al 21 por ciento de los pacientes presentaron datos de laboratorio de infección, alergias o de alteraciones autoinmunes, incluyendo niveles aumentados de factor de necrosis tumoral (sTNFÓ) en 41 por ciento, proteína C reactiva (CRP) positiva en 19.4 por ciento e incremento en los niveles de IgE (14.3 por ciento). Los de pacientes con SFC sin patogénesis identificable. Estos datos confirman el concepto de Demitrak acerca del SFC. De que no se trata de una entidad con una sola etiología sino que existen varios y diversos eventos que coinciden parcialmente y comparten las vías fisiopatológicas que finalmente resultan en este síndrome clínico