Search

Assessing the risk of cancer among people living with HIV (PLHIV) in the current era of antiretroviral therapy (ART) is crucial, given their increased susceptibility to many types of cancer and prolonged survival due to ART exposure. Our study aims to compare the association between HIV infection and specific cancer sites in Rwanda. Population‐based cancer registry data were used to identify cancer cases in both PLHIV and HIV‐negative persons. A probabilistic record linkage approach between the HIV and cancer registries was used to supplement HIV status ascertainment in the cancer registry. Associations between HIV infection and different cancer types were evaluated using unconditional logistic regression models. We performed several sensitivity analyses to assess the robustness of our findings and to evaluate the potential impact of different assumptions on our results. From 2007 to 2018, the cancer registry recorded 17,679 cases, of which 7% were diagnosed among PLHIV. We found significant associations between HIV infection and Kaposi's Sarcoma (KS) (adjusted odds ratio [OR]: 29.1, 95% CI: 23.2–36.6), non‐Hodgkin lymphoma (NHL) (1.6, 1.3–2.0), Hodgkin lymphoma (HL) (1.6, 1.1–2.4), cervical (2.3, 2.0–2.7), vulvar (4.0, 2.5–6.5), penile (3.0, 2.0–4.5), and eye cancers (2.2, 1.6–3.0). Men living with HIV had a higher risk of anal cancer (3.1, 1.0–9.5) than men without HIV, but women living with HIV did not have higher risk than women without HIV (1.0, 0.2–4.3). Our study found that in an era of expanded ART coverage in Rwanda, HIV is associated with a broad range of cancers, particularly those linked to viral infections. [ABSTRACT FROM AUTHOR]

Simple Summary: This research is focused on Kaposi sarcoma (KS), a cancer occurring usually among children and adults living with HIV. Despite improvements in HIV treatments, KS remains common in eastern and central Africa. KS in children manifests in many different ways, from small skin lesions to cancer throughout the body. KS edema is a version of the disease where patients develop hard, wood-like skin lesions causing decreased mobility and quality of life. This study analyzes data from over a decade of treating pediatric KS in Malawi and aims to better describe the disease in children. The findings emphasize the chronic nature of KS edema, its propensity to relapse, its impact on survival, and the need for improved long-term management strategies to reduce relapses and progression. This research provides important insights into the unique biology and clinical presentation of KS in children, helping to guide future treatment approaches in resource-limited settings. Background/Objectives: Kaposi sarcoma (KS) is a common lymphatic endothelial cancer among children with and without HIV in central and eastern Africa. Despite its clinical heterogeneity, its various clinical phenotypes are often grouped together in staging and treatment algorithms. Patients with KS tumor-associated edema, referring to hard, non-pitting lesions which often lead to chronic disability, represent a unique, understudied subgroup of children with KS. To continue our work defining the distinct phenotypes of pediatric KS, this study aimed to assess the clinical progression and outcomes of KS edema in children. Methods: A retrospective cohort study was conducted at Kamuzu Central Hospital in Lilongwe, Malawi, focusing on children diagnosed with KS edema between 2010 and 2023. Results: We identified 52 children with KS edema, representing 27% of all patients with KS. Initial chemotherapy resulted in a clinical response in 92% of patients, but 46% experienced relapse or disease progression with a median time to first relapse of 12 months. Multiple progressions were common, with 31% of patients experiencing two or more events. Event-free survival at two years was 32%, dropping to 24% at five years, while overall survival was 73% at two years and 57% at five years. Relapse was more common among patients with KS edema versus those without it (relative risk = 2.1; 95%CI, 1.4–3.2; p < 0.001). Eight patients (15%) relapsed with visceral disease, five of whom originally presented with KS edema alone. Conclusions: Patients with KS edema have a unique, relapsing-remitting pattern of disease with a high risk of relapse relative to other forms of KS with subsequent long-term mortality, even after initial positive treatment responses. Late relapse and mortality with visceral disease are possible even among children presenting initially with KS edema alone. Children with KS edema require long-term follow-up, and novel treatment approaches tailored towards preventing frequent relapse are needed. [ABSTRACT FROM AUTHOR]

Skin cancer, the most common cancer in the United States, has been well-described in the literature to be associated with environmental factors including ultraviolet (UV) radiation. However, the effect of chronic viral infections on risk of skin cancer development, particularly in individuals co-infected with Human Immunodeficiency Virus (HIV) and Hepatitis B or C Viruses (HBV/HCV), has yet to be elucidated. This systematic review aims to be one of the first to consolidate existing literature and examine the relationship between skin cancer and HIV/HBV and HIV/HCV co-infections. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching MEDLINE, Embase, Cochrane CENTRAL, and Web of Science databases for studies published from inception to March 26, 2024. Inclusion criteria for studies included only those reporting on HBV and/or HCV in people living with HIV (PLWH). Five studies were ultimately included for analysis. The review identified multiple non-melanoma skin cancers (NMSC) and cutaneous adnexal carcinomas in HIV/HCV or HIV/HBV co-infected patients. Notably, Pilomatrical carcinomas were observed in co-infected individuals. Sarcomas including Kaposi sarcoma and low-grade fibroblastic sarcoma were also linked to HIV/HCV or HIV/HBV infections. However, the studies primarily focused on specific types of cancers without elucidating the underlying mechanisms for the association between HIV/HCV/HBV infection and sarcoma development. In summary, this review suggests a potential link between HIV/HCV and HIV/HBV co-infection and certain types of skin cancer, namely adnexal carcinomas. Further research is crucial to determine the underlying mechanisms, explore the association with different skin cancer types, and identify effective prevention and treatment strategies for co-infected individuals. [ABSTRACT FROM AUTHOR]

De novo or viral reactivation cancers are a major cause of morbidity and mortality in the solid organ transplant (SOT) population. Primary sclerosing cholangitis (PSC) is an aggressive disease which can lead to cholestatic liver damage and cirrhosis. PSC often cooccurs with inflammatory bowel disease (IBD). Here, we describe the case of a 28‐year‐old male with PSC along with poorly controlled IBD who underwent a liver transplant and developed colonic Kaposi sarcoma (KS). Our case highlights the importance of adequate pretransplant screening for endemic viruses, high clinical suspicion for KS in the setting of difficult‐to‐control colitis, and early multidisciplinary involvement. [ABSTRACT FROM AUTHOR]

ABSTRACT Kaposi sarcoma is a human herpesvirus 8–associated angio‐proliferative tumor arising from lymphatic endothelial cells. Four clinical subtypes are known: classic, epidemic, endemic, and iatrogenic. The development of Kaposi sarcoma and lymphedema may be interlinked, where each condition could potentially support the progression of the other. Post‐mastectomy lymphedema is a commonly recognized complication following radical mastectomy. Angiosarcoma is the most frequently reported neoplasm in such a situation. We present a 72‐year‐old female who developed Kaposi sarcoma on the same side of mastectomy 9 years following her initial diagnosis and treatment for cancer breast. The diagnosis of Kaposi sarcoma was based on the histopathologic findings and was confirmed with immunohistochemical staining for human herpes virus 8 and D2‐40. Lymphedema may be associated with local immune suppression manifested in the form of defective cell–mediated immunity and antigen‐presenting cell migration defect which may facilitate development of neoplasms. It is important to differentiate Kaposi sarcoma from other vascular tumors which may have a much worse prognosis. Patients with lymphedema should receive appropriate management and undergo long‐term follow‐up for early detection of any potential malignancies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Birds, especially the chick and hen, have been important biomedical research models for centuries due to the accessibility of the avian embryo and the early discovery of avian viruses. Comprehension of avian tumor virology was a milestone in basic cancer research, as was that of non-viral genesis, as it enabled the discovery of oncogenes. Furthermore, studies on avian viruses provided initial insights into Kaposi's sarcoma and EBV-induced diseases. However, the role of birds in human carcinogenesis extends beyond the realm of virology research. Utilization of CAM, the chorioallantoic membrane, an easily accessible extraembryonic tissue with rich vasculature, has enabled studies on tumor-induced angiogenesis and metastasis and the efficient screening of potential anti-cancer compounds. Also, the chick embryo alone is an effective preclinical in vivo patient-derived xenograft model, which is important for the development of personalized therapies. Furthermore, adult birds may also closely resemble human oncogenesis, as evidenced by the laying hen, which is the only animal model of a spontaneous form of ovarian cancer. Avian models may create an interesting alternative compared with mammalian models, enabling the creation of a relatively cost-effective and easy-to-maintain platform to address key questions in cancer biology. [ABSTRACT FROM AUTHOR]

Simple Summary: Kaposi sarcoma-associated herpesvirus (KSHV) is associated with lymphoproliferative disorders, including primary effusion lymphoma and multicentric Castleman disease. KSHV expresses viral proteins that aid in the evasion of antiviral immune responses and manipulate host factors and signaling to promote cell survival. By altering the cell environment, KSHV contributes to lymphomagenesis. Approximately 15–20% of cancers are caused by viruses. Kaposi sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV8), is an oncogenic virus that is the etiologic agent of not only Kaposi sarcoma but also the lymphoproliferative disorders, primary effusion lymphoma (PEL) and multicentric Castleman disease (MCD). KSHV can infect a broad tropism of cells, including B lymphocytes, wherein KSHV encodes specific viral proteins that can transform the cell. KSHV infection precedes the progression of PEL and MCD. KSHV establishes lifelong infection and has two phases of its lifecycle: latent and lytic. During the latent phase, viral genomes are maintained episomally with limited gene expression. Upon sporadic reactivation, the virus enters its replicative lytic phase to produce infectious virions. KSHV relies on its viral products to modulate host factors to evade immune detection or to co-opt their function for KSHV persistence. These manipulations dysregulate normal cell pathways to ensure cell survival and inhibit antiviral immune responses, which in turn, contribute to KSHV-associated malignancies. Here, we highlight the known molecular mechanisms of KSHV that promote lymphomagenesis and how these findings identify potential therapeutic targets for KSHV-associated lymphomas. [ABSTRACT FROM AUTHOR]

Background: Preferentially expressed antigen in melanoma (PRAME) has been extensively studied in cutaneous melanocytic tumors and has proven valuable as a diagnostic adjunct in routine dermatopathology practice. However, its expression in cutaneous vascular neoplasms, particularly angiosarcomas (AS), remains largely unexplored. Methods: To further explore PRAME expression in cutaneous AS, 18 cases of post‐irradiation and 13 cases of primary cutaneous AS were evaluated for PRAME. For comparison, sections from 11 deep soft tissue/visceral AS, 10 Kaposi sarcomas, 8 microvenular hemangiomas, 7 infantile hemangiomas, 8 atypical vascular lesions, 6 epithelioid hemangioendotheliomas, 6 pyogenic granulomas, 6 papillary endothelial hyperplasias, 6 epithelioid hemangiomas, 3 capillovenous malformations, 3 hobnail hemangiomas, 2 spindle cell hemangiomas, 2 pseudomyogenic hemangioendotheliomas, and 2 composite hemangioendotheliomas were also retrieved. Results: Overall, 22 of 31 (70.9%; 12 post‐irradiation and 10 primary) cutaneous AS were positive for PRAME. In contrast, only 1 of 11 (9.1%) deep soft tissue/visceral AS showed diffuse and strong PRAME nuclear staining. All other tumor types were negative for PRAME, except for 5 of 7 (71.4%) infantile hemangiomas, which demonstrated rare (<5%; four cases) and 1+ (5–25%; one case) nuclear staining. Conclusions: In this study, we have demonstrated frequent nuclear PRAME expression in cutaneous AS. PRAME immunohistochemistry may serve as a valuable additional marker in selected clinical settings. [ABSTRACT FROM AUTHOR]

Background An improved understanding of oral Kaposi sarcoma–associated herpesvirus (KSHV) viral dynamics could provide insights into transmission risk and guide vaccine development. Methods We evaluated KSHV oral shedding dynamics in Ugandan adults stratified by Kaposi sarcoma (KS) and human immunodeficiency virus (HIV) status. Participants were followed for ≥4 weeks, with daily home oral swab collection to quantify KSHV using polymerase chain reaction. Shedding rates were defined by number of days with KSHV DNA detected divided by total days with swabs and compared by group using hurdle models. Results Two hundred ninety-five participants were enrolled; median age was 35 years (range, 18–71 years), and 134 (45%) were male. KSHV was detected more frequently among participants with KS (HIV positive [HIV+]/KS+, 56/76 [74%]; HIV negative [HIV−]/KS+, 9/18 [50%]) than those without KS (HIV+/KS−, 36/125 [29%]; HIV−/KS−, 16/76 [21%]); odds of shedding did not differ significantly by HIV status. Among participants with KSHV detected, shedding rates did not differ significantly by group. Median per-participant viral loads among positive samples were lowest in HIV+/KS+ (3.1 log10 copies/mL) and HIV−/KS+ (3.3 log10 copies/mL) participants relative to HIV+/KS− (3.8 log10 copies/mL) and HIV−/KS− (4.0 log10 copies/mL) participants. All groups had participants with low viral load intermittent shedding and participants with high viral load persistent shedding. Within each group, individual KSHV shedding rate positively correlated with median KSHV log10 copies/mL, and episode duration positively correlated with peak viral load. Conclusions Oral KSHV shedding is highly heterogeneous across Ugandan adults with and without KS and HIV. Persistent shedding is associated with higher median viral loads regardless of HIV and KS status. [ABSTRACT FROM AUTHOR]

The Herpesviridae include the Epstein–Barr Virus (EBV) and the Kaposi Sarcoma-associated Herpesvirus (KSHV), both of which are oncogenic gamma-herpesviruses. These viruses manipulate host cellular mechanisms, including through ubiquitin-mediated pathways, to promote viral replication and oncogenesis. Ubiquitin, a regulatory protein which tags substrates for degradation or alters their function, is manipulated by both EBV and KSHV to facilitate viral persistence and cancer development. EBV infects approximately 90% of the global population and is implicated in malignancies including Burkitt lymphoma (BL), Hodgkin lymphoma (HL), post-transplant lymphoproliferative disorder (PTLD), and nasopharyngeal carcinoma. EBV latency proteins, notably LMP1 and EBNA3C, use ubiquitin-mediated mechanisms to inhibit apoptosis, promote cell proliferation, and interfere with DNA repair, contributing to tumorigenesis. EBV's lytic proteins, including BZLF1 and BPLF1, further disrupt cellular processes to favor oncogenesis. Similarly, KSHV, a causative agent of Kaposi's Sarcoma and lymphoproliferative disorders, has a latency-associated nuclear antigen (LANA) and other latency proteins that manipulate ubiquitin pathways to degrade tumor suppressors, stabilize oncogenic proteins, and evade immune responses. KSHV's lytic cycle proteins, such as RTA and Orf64, also use ubiquitin-mediated strategies to impair immune functions and promote oncogenesis. This review explores the ubiquitin-mediated interactions of EBV and KSHV proteins, elucidating their roles in viral oncogenesis. Understanding these mechanisms offers insights into the similarities between the viruses, as well as provoking thought about potential therapeutic targets for herpesvirus-associated cancers. [ABSTRACT FROM AUTHOR]

The article discusses a case of iatrogenic Kaposi sarcoma (KS) in a Hispanic patient with rheumatoid arthritis (RA) due to treatment with Janus kinase (JAK) and tumor necrosis factor (TNF) α inhibitors. The patient developed disseminated lesions after starting methotrexate, baricitinib, and deflazacort, which worsened with golimumab. Treatment involved discontinuing immunosuppressive medications and using doxorubicin, peginterferon alfa‐2a, and valganciclovir, resulting in lesion regression. The study also reviews similar cases of RA patients developing iatrogenic KS from JAK and TNF‐α inhibitors, emphasizing the importance of considering this condition in autoimmune disease treatment. [Extracted from the article]

Objective: This study aims to examine the expression of androgen receptor (AR) and estrogen receptor (ER) in patients with classic Kaposi's sarcoma (CKS) in Xinjiang, as well as to assess the serum levels of sex hormones in these patients. The objective is to explore potential new directions and targets for diagnosing and treating CKS in Xinjiang. Methods: The case group comprised 35 patients diagnosed with CKS who presented at our hospital from 2014 to 2021. The control group consisted of 35 patients with pyogenic granuloma (PG) who visited the hospital during the same period, selected using propensity score matching (PSM). Immunohistochemistry was used to detect AR, human herpesvirus type 8 (HHV‐8), and ER in paraffin‐embedded tissue samples from patients diagnosed with CKS and PG. Additionally, enzyme‐linked immunosorbent assay (ELISA) was used to quantitatively measure serum sex hormone levels in the 35 patients with CKS and 35 patients with PG. Results: AR expression was relatively weak in both the CKS and PG groups, with the PG group exhibiting a slightly stronger expression than the CKS group. Conversely, the expression of ER was significantly higher in the CKS group compared to the PG group (p < 0.05). Additionally, serum testosterone (T) levels were elevated in the CKS group, while serum estradiol (E2) levels were higher in the PG group (p < 0.05). Conclusion: Sex hormones and their receptors are implicated in the pathogenesis of CKS in Xinjiang. The use of ER antagonists may represent a novel avenue for research and treatment of CKS. [ABSTRACT FROM AUTHOR]

The frequency of virus-associated cancers is growing worldwide, especially in resource-limited settings. One of the biggest challenges in cancer research among people living with HIV (PLWH) has been understanding how infection with both HIV and Kaposi sarcoma-associated herpesvirus (KSHV) promotes the pathogenesis of Kaposi sarcoma (KS), the most common cancer among PLWH worldwide and a significant public health problem in regions with high prevalence of HIV such as Sub-Saharan Africa (SSA). The AIDS and Cancer Specimen Resource (ACSR) provides samples for research, including dried blood spots (DBS) that were collected from large clinical epidemiology studies of KSHV and KS in PLWH conducted more than a decade ago in SSA. Here, we validated the quality of DNA derived from DBS samples from SSA studies and provided evidence of quantitative recovery of inflammatory cytokines using these DBS samples through comparison with paired frozen plasma. Significant differences in DNA, protein yields, and inflammatory biomarker levels were also observed between PLWH with/without KS. Establishing the fitness of DBS samples for studies of KS pathogenesis extends the number of projects that can be supported by these ACSR special collections and provides evidence that DBS collection for future KS research is a practical option in resource-limited settings. [ABSTRACT FROM AUTHOR]

Paclitaxel is one of the most widely utilized anticancer drug. It displays a range of antitumor action, particularly against ovarian cancer, urologic malignancies, head tumor, and Kaposi's sarcoma. However, due to its highly lipophilic nature, poor fluid dissolvability of less 0.01 mg/mL and lack of ionizing functionalities which may enhance its solubility, there are substantial challenges associated with Paclitaxel delivery. Paclitaxel exhibited promising effects when formulated in combination with ethanol and Cremophor EL, as Taxol®. However, it is associated with various side effects, including hypersensitivity, hypotension, and peripheral neuropathy. The albumin-based Paclitaxel, Abraxane®, is a superior alternative to Taxol® as it diminishes the side effects related to Cremophor EL. Abraxane® is regarded as the gold standard for cancer treatment, but its 21% response rate suggests that more research is needed. Furthermore, the large-scale clinical use of this drug has faced considerable delay because of the absence of suitable delivery vehicles. Therefore, necessitates is the development of an alternate form of Paclitaxel that has both superior aqueous solubility as well as fewer side-effects. During the last decade, various methodologies have been explored to improve Paclitaxel's solubility with the help of co-solvents and inclusion complexes. Additionally, various methodologies report of passive targeting of cancer cells using nanoparticles, nanosuspensions, Rotaxane (a mechanically interlocked molecular system), liposomes, micelles, emulsions, gels, pastes, etc. Herein, we have comprised a brief report on various delivery techniques for Paclitaxel with improved therapeutic outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to describe the prevalence of high‐risk human papillomavirus (HR‐HPV) types in the anal canal in a cohort of people living with HIV (PLWHIV) with a history of malignancy. Setting: Referral tertiary care hospital for adult patients with cancer. Methods: We reviewed data of patients from the AIDS Cancer Clinic on antiretroviral therapy in chronic control who were consecutively referred for high‐resolution anoscopy (HRA), where they underwent anal evaluation, collection of specimens for anal cytology and anal human papillomavirus (HPV) followed by HRA with directed biopsy if needed. Results: A total of 155 patients were included; 149 (96.1%) were men, all of them men who have sex with men (MSM); the median age was 39 (IQR 32‐47) years; 105 (67.7%) with Kaposi sarcoma, 40 (25.8%) with non‐Hodgkin lymphoma and 10 (6.4%) with other neoplasms; only 7 (4.5%) had active cancer. The prevalence of HR‐HPV infection was 89% (n=138) (95% CI 83–93) with at least one HR‐HPV infection, and 62% (96) had coinfection with at least two types; the median HR‐HPV types of coinfection were 3 (IQR 2–4). The number of patients infected with HPV 16 was 64 (41.3%, 95% CI 33.8–49.3), HPV 18 was 74 (47.7%, 95% CI 39.9–55.7) and with both 35 (22.6%). Some 59 patients (38%) had high‐grade squamous intraepithelial lesions (HSIL) and 49 (31.6%) had low‐grade squamous intraepithelial lesions (LSIL). The prevalence of HR‐HPV and HSIL among patients aged ≤35 and >35 years was the same. Conclusions: In this cohort of PLWHIV with a history of malignancy we found a high prevalence of HR‐HPV 16 and 18 and anal HSIL, even in persons aged ≤35 years. These data highlight the importance of anal cancer screening in PLWHIV and history of malignancy. [ABSTRACT FROM AUTHOR]

Objectives. Emmprin (CD147/BSG) protein is estimated to play a key role in cell migration and chemoresistance in viral carcinogenesis. However, there are very limited studies investigating the CD147 in the oncogenesis of Kaposi's sarcoma-associated herpesvirus. This study aims to reveal the relationship between CD147 expression with histopathological parameters, disease pattern, and recurrence in Kaposi's sarcoma (KS). Methods. The study included 67 patients diagnosed with KS between January 1982 and September 2023. Clinical and histopathological features were analyzed retrospectively. HHV-8, CD31, and CD147 expressions were evaluated by immunohistochemistry. Results. Sixteen (24%) female and 51 (76%) male patients with median age of 64 (10-86) were included in the study. CD147 was positive in 57 (85%) cases and associated with nodular pattern (P =.001), presence of solid/fibrosarcomatous area (P =.005), and high mitotic activity (P =.035). The disease relapsed in 17 (27%) of the 63 patients with median 2 (0-12) years follow-up. While a 5-year relapse-free survival was 48.5% in the CD147 diffuse positive group, it was 83.4% in focal positive and 100% in negative cases (P =.029). Conclusion. Our study exhibited the relationship between CD147 overexpression and recurrence in KS, but the inhomogeneity of the treatment groups and the small number of patients should also be considered. These findings may provide insight into the pathogenesis of KS and the development of targeted therapies in the future. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus-associated Kaposi's sarcoma (HIV-KS) is a well-documented vascular tumor with a pathogenesis involving human herpesvirus-8 (HHV-8) infection. While antiretroviral therapy (ART) and chemotherapy are effective for treating most KS cases, some become refractory. In this report, we present a case of a 58-year-old man with refractory HIV-KS treated with ART and chemotherapy. Chemotherapy was eventually discontinued due to an adverse reaction, and the patient presented with painful plantar lesions that impaired ambulation. With the exclusion of visceral metastases, localized radiotherapy was administered, which resulted in significant cosmetic and functional improvements. The patient regained ambulation and lived independently, receiving additional radiotherapy as needed. This case underscores the potential use of radiotherapy for the treatment of ART-resistant KS, particularly when the patient is unresponsive to conventional chemotherapy. It also highlights the need for future research in this area. [ABSTRACT FROM AUTHOR]

Kaposi's Sarcoma Herpesvirus (KSHV) is the causative agent of several human diseases. There are no cures for KSHV infection. KSHV establishes biphasic lifelong infections. During the lytic phase, new genomes are replicated by seven viral DNA replication proteins. The processivity factor's (PF‐8) functions to tether DNA polymerase to DNA, so new viral genomes are efficiently synthesized. PF‐8 self‐associates, interacts with KSHV DNA replication proteins and the viral DNA. Inhibition of viral DNA replication would diminish the infection within a host and reduce transmission to new individuals. In this review we summarize PF‐8 molecular and structural studies, detail the essential protein‐protein and nucleic acid interactions needed for efficient lytic DNA replication, identify future areas for investigation and propose PF‐8 as a promising antiviral target. Additionally, we discuss similarities that the processivity factor from Epstein‐Barr virus shares with PF‐8, which could promote a pan‐herpesvirus antiviral therapeutic targeting strategy. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic prompted the rapid development of vaccines, including the ChAdOx1 nCov-19 (AstraZeneca) vaccine. While effective, adverse effects have been reported, including cutaneous manifestations. Kaposi sarcoma (KS), a vascular tumor linked to Kaposi sarcoma herpesvirus/human herpesvirus 8 (HHV-8), has seen increased detection during the pandemic. This study reports a case of classic cutaneous KS in a 79-year-old male following the first dose of the ChAdOx1 nCov-19 vaccine, without prior SARS-CoV-2 infection. The patient developed multiple reddish-blue papules on his legs and feet, confirmed as KS through histopathology. Treatment included radiotherapy and sequential chemotherapy with Doxorubicin. The potential reactivation of latent HHV-8 by the vaccine is explored through mechanisms involving the SARS-CoV-2 spike protein and adenovirus vector, which may induce immune responses and inflammatory pathways. Although establishing a direct causal link remains challenging, the case highlights the need for vigilance regarding KS reactivation post-vaccination. Further large-scale studies are warranted to elucidate the relationship between COVID-19 vaccines and latent virus reactivation, ensuring comprehensive safety assessments and informed public health decisions. [ABSTRACT FROM AUTHOR]

Abstract The co‐occurence of multicentric Castleman's disease (MCD) and Kaposi's sarcoma (KS) represents a rare clinical entity, mostly observed in individuals infected with the human immunodeficiency virus (HIV). Human herpesvirus 8 (HHV‐8) is attributed a crucial etiological role in both conditions. This study presents the case of a 75‐year‐old woman who manifested an angiomatous lesion on the right thigh and erythematous firm plaques on the trunk and limbs, accompanied by asthenia, weight loss, and recurrent febrile episodes. Serological markers for HIV yielded negative results. Contrast‐enhanced computed tomography (CT) and fluorine‐18 fluorodeoxyglucose positron emission tomography (18 F FDG PET/CT) revealed multiple enlarged and intensely hypermetabolic lymph nodes in the supraclavicular, cervical, thoracic, and abdominopelvic regions. Subsequent excisional biopsy and immunohistochemical analysis confirmed the diagnosis of HIV‐negative HHV8‐positive MCD coexisting with KS.

Introduction. According to the European Cancer Information System, melanoma is the sixth most diagnosed cancer in Europe (following breast, colorectal, prostate, lung, and bladder cancer) and ranks among the top 20 most common causes of cancer-related death. The diagnosis of melanoma can be a clinical challenge due to the variety of signs and symptoms, ranging from small, asymptomatic lesions with slow progression to large, painful tumors with rapid growth. In this paper, we will report an exceptional case of cutaneous melanoma with an atypical presentation in a patient with no personal or family history of skin cancer. Case presentation. We present the case of an 85-year-old patient who presented to our dermatology clinic with multiple nodular lesions on her right calf, extending to her thigh as isolated lesions. These violaceous lesions varied in size and displayed signs of bleeding, fibrin deposits, and purulent, foul-smelling discharge. The patient reported a fivemonth history of rapid tumor progression. The initial presumptive diagnosis was Kaposi's sarcoma; however, the biopsy ruled out this diagnosis, revealing the presence of malignant melanoma. Given the extensive locoregional spread and invasion of deep structures, the patient was transferred to palliative care. Conclusions. Melanoma is an aggressive form of cancer that can rapidly progress, often presenting with atypical clinical manifestations or mimicking other skin conditions. When the clinical presentation deviates from the classic patterns, a biopsy is considered the gold standard for guiding the clinician's subsequent approach. It provides valuable diagnostic information and aids in determining the prognosis as well as the appropriate therapeutic course.

Background: AIDS related Kaposi’s sarcoma (KS) is an AIDS-defining illness and is now increasingly recognized in children infected with HIV. Many of these cases are missed due to low index of suspicion. Vertical transmission of HIV is the commonest route of transmission in children and this is preventable by early maternal antenatal diagnosis, early commencement of HAART by the mother and adoption of the safest possible mode of delivery. The index case did not benefit from these services, making her acquire HIV and then develop AIDS-defining illness (KS) at a tender age of 4 years. Aim and objective: The study is aimed at emphasizing the need for all pregnant women to have antenatal screening as soon as pregnancy is confirmed so as to prevent vertical transmission of HIV to the unborn child. It is also aimed at creating awareness in clinical practice so as to increase index of suspicion among clinicians when evaluating chronically ill children. Case Description: GG was a 4year old girl who presented at 108 Nigerian Air force Hospital, Abuja with non-itchy skin rashes of two weeks duration, generalized body swelling, cough and haematochezia of one week duration, and fever of four days duration. She was a paternal orphan having lost her father a year prior to presentation to Acquired immunodeficiency syndrome (AIDS)-related illness. Her mother also tested positive to Human Immunodeficiency virus (HIV) and has been on highly active anti-retroviral therapy (HAART) for a year. Physical examination revealed moderate pallor, bilateral pitting pedal oedema, and matted non-tender peripheral lymphadenopathy. There were papular and nodular skin lesions with a reddish solid lesion on the hard palate. She tested positive to HIV. Abdominal ultrasound scan revealed moderate hepatomegaly with ascites, while chest x-ray showed bilateral interstitial pneumonitis, right hilar lymphadenopathy, right pulmonary nodule and ipsilateral pleural effusion. Excisional biopsy of one of the skin nodules confirmed the diagnosis of Kaposi’s sarcoma. She was commenced on HAART and antibiotics, with a unit of blood transfused. Her condition deteriorated, which necessitated referral to university of Abuja Teaching Hospital where she eventually died after a day of admission. Conclusion: Paediatric AIDSrelated KS is becoming increasingly common in Nigeria and as such, high index of suspicion is required while evaluating pediatric patients. This, coupled with early commencement of with early commencement of HAART is required to avert the pitfalls observed in this case; bearing in mind that childhood AIDSrelated KS is lethal.

Backgrounds: Kaposi sarcoma (KS) is a unique form of cancer with epidemiological characteristics distinct from those of other solid cancers. While common risk factors including alcohol consumption, smoking, and metabolic disorders have been well studied in various cancers, their relationship with KS remains unclear. Methods: This study used a cohort approach with adults without AIDS, utilizing data from the National Health Insurance Service in South Korea. This study examined various conventional cancer-related risk factors related to the incidence of KS, including psoriasis. Results: Alcohol consumption, smoking, body mass index, diabetes mellitus, hypertension, hypercholesterolemia, and regular exercise were not significantly associated with the incidence of KS. Additionally, older age and male sex were associated with a higher incidence of KS. KS risk was increased in pathological conditions such as psoriasis and proteinuria, which require immunosuppressive medication. Conclusions: Our study suggests that traditional cancer-related risk factors may not play a significant role in the pathogenesis of KS, unlike other cancers. This, in turn, emphasizes the importance of immunosuppression and HHV-8 infection in the development of KS. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aimed to evaluate the efficacy of radiotherapy for skin lesions in classic Kaposi's sarcoma. A retrospective analysis was performed. Response after radiotherapy was defined as follows: Complete response indicated no clinically detectable skin lesions and no symptoms. Partial response was defined as a reduction in lesion height by more than half or a lighter lesion color compared to before treatment. In-field recurrence was defined as the appearance of new lesions within a previously irradiated field. The overall response rate was 100%. The efficacy of radiotherapy was evident, even in cases involving disseminated lesions. Further research on the optimal dose and fractionation is deemed necessary. Objectives: Classic Kaposi's sarcoma (CKS) is a rare malignancy with diverse clinical presentations, lacking a standard treatment. While localized therapies are commonly used for symptomatic lesions, radiotherapy (RT) has demonstrated effectiveness. This study aims to evaluate the efficacy of RT for treating skin lesions in CKS. Methods: A retrospective analysis was conducted on patients with KS treated between April 2012 and January 2024. In total, 69 lesions in 16 patients were included. Treatment response was defined as follows: complete response (CR) indicated the absence of clinically detectable skin lesions and symptoms; partial response (PR) was a reduction in lesion height by more than half or a lighter lesion color compared to before treatment. In-field recurrence was the appearance of new lesions within a previously irradiated field. Logistic regression analysis was used to investigate factors influencing response and in-field recurrence. Results: The median follow-up period was 52 months (range, 3–138 months). The overall response rate was 100%, with 92.8% of the patients achieving CR and 7.2% receiving PR. PR was observed in three patients with five lesions, all of which remained stable. In-field recurrence occurred in two patients with initially advanced disease, and all recurrent lesions responded to RT. No variables were significantly associated with response or in-field recurrence. Conclusions: RT for CKS showed a 100% response rate, with complete symptom relief in all cases. The effectiveness of RT was evident, even in cases involving disseminated lesions. Further research is needed to determine the optimal RT dose and fractionation. [ABSTRACT FROM AUTHOR]

Although extensively studied in cutaneous epithelial neoplasms, the TRPS1 immunoreactivity in cutaneous mesenchymal neoplasms and tumors of uncertain differentiation (CMNTUDs), such as atypical fibroxanthoma (AFX), remains largely unexplored. We assessed TRPS1 immunoreactivity in 135 CMNTUDs, comprising 46 fibrohistiocytic/fibroblastic tumors, 28 vascular tumors, 24 peripheral nerve sheath tumors (PNSTs), 21 tumors of uncertain differentiation, and 16 smooth muscle tumors. Additionally, we included selected cases of melanoma with spindled cell morphology or desmoplastic features (n = 9) and sarcomatoid squamous cell carcinoma (SSCC) (n = 5) to compare TRPS1 expression patterns with those of AFX. TRPS1 expression was prevalent in dermatofibromas (24/24), leiomyomas (8/8), AFXs/pleomorphic dermal sarcoma (PDS) (20/21), dermatofibrosarcomas protuberans (14/22), and leiomyosarcomas (6/8). It was uncommon in angiosarcomas (3/20), Kaposi sarcomas (2/8), and neurofibromas (5/17) and absent in perineuriomas (0/2). AFXs/PDS exhibited the highest median H-score of 240, contrasting with minimal TRPS1 immunoreactivity in vascular neoplasms and PNSTs, with median H-scores consistently below 10. Significant differences in H-score were observed between AFXs/PDS and angiosarcomas (p < 0.001), melanomas (p < 0.001), and leiomyosarcomas (p = 0.029). However, no significant difference was found compared to SSCCs, suggesting limited discriminatory power of TRPS1 in this context. This study sheds light on TRPS1 expression patterns in a subset of CMNTUDs, extending beyond prior studies primarily focused on epithelial tumors, while underscoring potential pitfalls associated with TRPS1 immunohistochemistry. [ABSTRACT FROM AUTHOR]

Kaposi's sarcoma-associated herpesvirus (KSHV) is a cancer-causing virus that establishes life-long infection. KSHV is implicated in the etiology of Kaposi's sarcoma, and a number of rare hematopoietic malignancies. The present study focuses on the KSHV open reading frame 20 (ORF20), a member of the conserved herpesvirus UL24 protein family containing five conserved homology domains and a conserved PD-(D/E)XK putative endonuclease motif, whose nuclease function has not been established to date. ORF20 encodes three co-linear protein isoforms, full length, intermediate, and short, though their differential functions are unknown. In an effort to determine the role of ORF20 during KSHV infection, we generated a recombinant ORF20-Null KSHV genome, which fails to express all three ORF20 isoforms. This genome was reconstituted in iSLK cells to establish a latent infection, which resulted in an accelerated transcription of viral mRNAs, an earlier accumulation of viral lytic proteins, an increase in the quantity of viral DNA copies, and a significant decrease in viral yield upon lytic reactivation. This was accompanied by early cell death of cells infected with the ORF20-Null virus. Functional complementation of the ORF20-Null mutant with the short ORF20 isoform rescued KSHV production, whereas its endonuclease mutant form failed to enhance lytic reactivation. Complementation with the short isoform further revealed a decrease in cell death as compared with ORF20-Null virus. Finally, expression of IL6 and CXCL8, previously shown to be affected by the hCMV UL24 homolog, was relatively low upon reactivation of cells infected with the ORF20-Null virus. These findings suggest that ORF20 protein, with its putative endonuclease motif, promotes coordinated lytic reactivation for increased infectious particle production. [ABSTRACT FROM AUTHOR]

Kaposi's Sarcoma (KS) is a malignant vascular tumor commonly seen in immunocompromised individuals, particularly patients with acquired immunodeficiency syndrome. Lung transplant recipients are at high risk of developing KS due to a strong immunosuppressive regimen that can lead to donor-derived infection or reactivation of recipient human herpesvirus 8, the causative organism for KS. In this overview, we describe 2 lung transplant recipients who developed pulmonary KS with poor outcomes, reviewing the diagnosis, bronchoscopy findings, and treatment and surveillance strategies for pulmonary KS. [ABSTRACT FROM AUTHOR]

Background Reemergence of human herpesvirus 8 (HHV-8)–induced Kaposi sarcoma (KS) in people living with HIV (PLWH) despite antiretroviral therapy (ART) poses a clinical challenge because they already have favorable CD4 T-cell numbers and undetectable viral loads. We observed that clinical presentation in PLWH on ART resembled classic KS found in older HIV-uninfected patients and hypothesized that immunosenescence may thus play a role in occurrence of KS on ART. We compared viral and immune factors implicated in the development of KS in ART-treated PLWH (HIV KS) and HIV-uninfected classic KS patients (cKS), compared to controls without KS (HIV Control, cControls respectively). Methods Plasma, peripheral blood mononuclear cell, and skin tissues were obtained from 11 HIV KS and 11 cKS patients and 2 groups of age-matched controls. Results HIV KS participants were younger than cKS (aged 53 vs 75 years). HHV-8 genotypes did not differ between groups. Despite the younger age and a lower CD4/CD8 ratio, activated, exhausted, and senescent T-cell frequencies were similar between HIV KS and cKS. Anti–HHV-8 immunoglobulin G levels were higher and circulating HHV-8 DNA lower in HIV KS compared with cKS. Circulating platelet-derived growth factors AA-BB and granulocyte colony-stimulating factors were higher in HIV KS We observed similar levels of HHV-8 DNA and PD-1 expression in skin lesions from HIV KS and cKS patients. Conclusions Altogether, early immune senescence could be involved in the development of KS in ART-treated PLWH. Higher anti–HHV-8 immunoglobulin G levels could be linked with lower circulating viral load. Such insights should help developing therapeutical strategies to prevent development and treat KS in PLWH on ART. [ABSTRACT FROM AUTHOR]

Background: Kaposi sarcoma (KS) is a multicentric vascular and lymphatic neoplasm caused by human herpesvirus 8 (HHV‐8). It generally concerns the elderly and immunosuppressed population. Four major clinical types of KS have been described. The most common subtype is Classical KS (CKS). Objectives: Our retrospective study aimed to better define prognostic subgroups among patients with CKS, which is the most common in our country. Method: Between 2014 and 2020, 43 patients with CKS were treated with local excision, radiotherapy and chemotherapy. Reviewed information included demographics, clinical features, laboratory findings, treatment responses and overall survival. Results: During the follow‐up, eight patients (18.6%) died of CKS. The complete response rate was 46.5%, partial response and stable disease 51.2%, and progressive disease 2.3% of all patients. Gender, haemoglobin level at diagnosis, and disseminated involvement were prognostic factors affecting survival in all patients. Conclusion: We confirmed that male gender, low haemoglobin levels, and disseminated involvement are associated with poor prognosis in CKS patients. It is the only Turkish study in which prognostic analysis was performed for this rare cancer. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus/Acquired immunodeficiency virus (HIV/AIDS) is well known to be a major public health problem globally. On the other hand, HIV/AIDS is associated with various otorhinolaryngological manifestations. On the other hand, there has been a global reduction in the burden of otorhinolaryngological manifestations since the introduction of highly active antiretroviral therapy though there are limited studies on otorhinolaryngological manifestations among HIV/AIDS patients in Tanzania. A hospital based descriptive cross-sectional study was conducted at Ilala District in Dar es Salaam from November 2022 to March 2023 where 380 study participants were recruited using convenience sampling technique. Data was collected using pre-tested semi-structured questionnaires and analysis was done by means of Statistical Package for Social Sciences (SPSS) version 23. Of all the 380 patients recruited in this study, 22 (5.8%) had otorhinolaryngological manifestations. Most of the patients with otorhinolaryngological manifestations were males (6.1%) in the age group 0–9 years (23.1%) followed by those aged 10–19 years (18.8%). The commonest otorhinolaryngological manifestations were allergic rhinitis (22.7%) and otitis externa (22.7%) followed by hearing loss (18.2%), Kaposi's sarcoma (13.7%), tonsillitis (9.1%), chronic suppurative otitis media, (4.5%) sinusitis (4.5%) and adenoid hypertrophy (4.5%). Otitis externa predominated in males (23.1%) while allergic rhinitis predominated in females (33.3%). Similarly, a significant association was found between the occurrence of otorhinolaryngological manifestations with CD4 counts (p-value = 0.001) and viral load (p-value = 0.000). Otorhinolaryngological manifestations among patients living with HIV/AIDS and on highly active antiretroviral therapy were less prevalent. Males outnumbered females in terms of being affected by otorhinolaryngological manifestations. Allergic rhinitis and otitis externa were the commonest otorhinolaryngological manifestations and most of participants with otorhinolaryngological manifestations had viral load of greater than 100 copies and CD4 counts of less than 200cells/mm3. [ABSTRACT FROM AUTHOR]

Background: Renal transplant recipients (RTRs) are prone to skin cancer due to the immunosuppression required to maintain graft function. Existing studies of skin cancer in RTRs focus on patients with Fitzpatrick skin types I‐II, with limited documentation of incidence in skin types III‐VI. This study seeks to better characterize skin cancers in RTRs with skin types III‐VI. Primary aims: Compare the incidence of skin cancer in RTRs of skin types I‐II with skin types III‐VI. Secondary aims: Explore the association between the development of skin cancer and other contributing factors in RTRs of skin types I‐VI. Methods: Retrospective chart review of RTRs at a single institution between January 1, 2000 and December 31, 2022. Patients were followed from the date of transplant to the last clinical follow‐up or death. 777 RTRs were included in the study, including 245 patients with Fitzpatrick skin types I‐II and 532 with skin types III‐VI. A total of 48 patients developed NMSCs, 2 patients developed melanoma, and 3 patients developed Kaposi sarcoma. Results and conclusions: There is a higher incidence of skin cancer in RTRs with Fitzpatrick skin types III‐VI compared to the reported incidence among non‐transplant recipients of the same skin types, but the incidence remains considerably lower compared to RTR of skin types I‐II. [ABSTRACT FROM AUTHOR]

Kaposi’s sarcoma herpesvirus (KSHV) ORF34 plays a significant role as a component of the viral pre-initiation complex (vPIC), which is indispensable for late gene expression across beta- and gammaherpesviruses. Although the key role of ORF34 within the vPIC and its function as a hub protein have been recognized, further clarification regarding its specific contribution to vPIC functionality and interactions with other components is required. This study employed a deep learning algorithm-assisted structural model of ORF34, revealing highly conserved amino acid residues across human beta- and gammaherpesviruses localized in structured domains. Thus, we engineered ORF34 alanine-scanning mutants by substituting conserved residues with alanine. These mutants were evaluated for their ability to interact with other vPIC factors and restore viral production in cells harboring the ORF34-deficient KSHV-BAC. Our experimental results highlight the crucial role of the four cysteine residues conserved in ORF34: a tetrahedral arrangement consisting of a pair of C-Xn-C consensus motifs. This suggests the potential incorporation of metal cations in interacting with ORF24 and ORF66 vPIC components, facilitating late gene transcription, and promoting overall virus production by capturing metal cations. In summary, our findings underline the essential role of conserved cysteines in KSHV ORF34 for effective vPIC assembly and viral replication, thereby enhancing our understanding of the complex interplay between the vPIC components. IMPORTANCE The initiation of late gene transcription is universally conserved across the beta- and gammaherpesvirus families. This process employs a viral pre-initiation complex (vPIC), which is analogous to a cellular PIC. Although KSHV ORF34 is a critical factor for viral replication and is a component of the vPIC, the specifics of vPIC formation and the essential domains crucial for its function remain unclear. Structural predictions suggest that the four conserved cysteines (C170, C175, C256, and C259) form a tetrahedron that coordinates the metal cation. We investigated the role of these conserved amino acids in interactions with other vPIC components, late gene expression, and virus production to demonstrate for the first time that these cysteines are pivotal for such functions. This discovery not only deepens our comprehensive understanding of ORF34 and vPIC dynamics but also lays the groundwork for more detailed studies on herpesvirus replication mechanisms in future research. [ABSTRACT FROM AUTHOR]

Kaposi's sarcoma (KS) is an angio‐proliferative disease with a viral etiology and a multifactorial pathogenesis that results from immune dysfunction. In patients affected by latent viral infections such as herpesviruses, SARS‐CoV‐2 infection may result in lytic cycle reactivation in host cells. A robust immune system response is crucial for eliminating pathogens and resolving both latent and non‐latent viral infections. We report a case series of KS characterized by tumor progression after SARS‐CoV‐2 infection. We performed a systematic literature review of the PubMed/MEDLINE and EMBASE databases. The keyword terms included "SARS‐CoV‐2," "HHV‐8," "Kaposi's sarcoma," "IL‐6," and "COVID‐19." English language restriction was applied. Items not covered by our study were excluded. KS is a complex disease linked to an impaired immune system. Conditions that result in temporary or permanent immunodeficiency can trigger viral reactivation or exacerbate an existing disease. It is feasible that the increase in cytokine levels in COVID‐19 patients, coupled with lymphocyte downregulation and treatment that induces herpesvirus lytic reactivation, may contribute to the progression of KS after SARS‐CoV‐2 infection. These observations suggest that patients with KS should be clinically monitored both during and after SARS‐CoV‐2 infection. Nevertheless, prospective data should be collected to validate this hypothesis and enhance our understanding of the mechanisms implicated in the onset or progression of KS. [ABSTRACT FROM AUTHOR]

Kaposi sarcoma (KS) is a neoplasm of vascular origin that promotes angiogenesis and the growth of endothelial cells triggered by the Kaposi Sarcoma‐associated Herpes Virus (KSHV). When associated with HIV, KSHV becomes more aggressive and rapidly evolves. The HIV‐1 TAT protein can be essential in developing AIDS‐associated KS by promoting angiogenesis and increasing KSHV replication. Therefore, we evaluated the genetic profile of the first exon of tat gene among groups of people living with HIV (PLHIV) with (case group, n = 36) or without KS, this later with (positive control group, n = 46) and without KSHV infection (negative control group, n = 24); all individuals under antiretroviral therapy. The genetic diversity, the DN/DS ratio, and the genetic entropy of the first exon of tat were higher in the case group, followed by the positive control group, which was higher than the negative control group. The number of tat codons under positive selection was seven in the case group, six in the positive control group, and one in the negative control group. The prevalence of HIV viral loads below the detection limit was equal in the case and positive control groups, which were lower than in the negative control group. The mean CD4+ T cell counts were higher in the negative control group, followed by the positive control group, and followed by the case group. These results emphasize the negative influence of KSHV in antiretroviral treatment, as well as the HIV‐specific TAT profile among PLHIV who developed KS. [ABSTRACT FROM AUTHOR]

Recently published near full-length KSHV genomes from a Cameroon Kaposi sarcoma case-control study showed strong evidence of viral recombination and mixed infections, but no sequence variations associated with disease. Using the same methodology, an additional 102 KSHV genomes from 76 individuals with KSHV-associated diseases have been sequenced. Diagnoses comprise all KSHV-associated diseases (KAD): Kaposi sarcoma (KS), primary effusion lymphoma (PEL), KSHV-associated large cell lymphoma (KSHV-LCL), a type of multicentric Castleman disease (KSHV-MCD), and KSHV inflammatory cytokine syndrome (KICS). Participants originated from 22 different countries, providing the opportunity to obtain new near full-length sequences of a wide diversity of KSHV genomes. These include near full-length sequence of genomes with KSHV K1 subtypes A, B, C, and F as well as subtype E, for which no full sequence was previously available. High levels of recombination were observed. Fourteen individuals (18%) showed evidence of infection with multiple KSHV variants (from two to four unique genomes). Twenty-six comparisons of sequences, obtained from various sampling sites including PBMC, tissue biopsies, oral fluids, and effusions in the same participants, identified near complete genome conservation between different biological compartments. Polymorphisms were identified in coding and non-coding regions, including indels in the K3 and K15 genes and sequence inversions here reported for the first time. One such polymorphism in KSHV ORF46, specific to the KSHV K1 subtype E2, encoded a mutation in the leucine loop extension of the uracil DNA glycosylase that results in alteration of biochemical functions of this protein. This confirms that KSHV sequence variations can have functional consequences warranting further investigation. This study represents the largest and most diverse analysis of KSHV genome sequences to date among individuals with KAD and provides important new information on global KSHV genomics. Author summary: The prevalence of KSHV infection, one of eight viruses associated with human cancer, differs geographically as does the incidence of Kaposi sarcoma and other KSHV-associated diseases. Distribution of KSHV subtypes, defined solely by the sequence of the K1 gene, also differs by region. One hundred and two near full-length KSHV genomes from people with associated diseases from a wide variety of countries were sequenced, substantially increasing the number and diversity of KSHV genomes publicly available, thereby allowing the analysis of variance across geographical regions, potential contributions of viral genetics to the risk of disease, and viral evolution. Our data demonstrate that viral recombination is common, as previously published, and that infections with multiple KSHV genomes may also be frequent, which has not been widely reported. We did not find evidence of an association between viral subtypes and disease nor indications that different sampling sites from the same individual, including tumor specimens, harbored substantially different KSHV genomes. Our data significantly inform the current efforts to study epidemiology and the prevention of KSHV infection, including vaccine development, as well as the pathogenesis of associated diseases. [ABSTRACT FROM AUTHOR]

Kaposi's sarcoma–associated herpesvirus (KSHV) is an oncogenic herpesvirus that is linked directly to the development of Kaposi's sarcoma. KSHV establishes a latent infection in B cells, which can be reactivated to initiate lytic replication, producing infectious virions. Using pharmacological and genetic silencing approaches, we showed that the voltage-gated K+ channel Kv1.3 in B cells enhanced KSHV lytic replication. The KSHV replication and transcription activator (RTA) protein increased the abundance of Kv1.3 and led to enhanced K+ channel activity and hyperpolarization of the B cell membrane. Enhanced Kv1.3 activity promoted intracellular Ca2+ influx, leading to the Ca2+-driven nuclear localization of KSHV RTA and host nuclear factor of activated T cells (NFAT) proteins and subsequently increased the expression of NFAT1 target genes. KSHV lytic replication and infectious virion production were inhibited by Kv1.3 blockers or silencing. These findings highlight Kv1.3 as a druggable host factor that is key to the successful completion of KSHV lytic replication. Editor's summary: Kaposi's sarcoma is driven by Kaposi's sarcoma–associated herpesvirus (KSHV), which preferentially infects B cells. Carden et al. identified a role for the voltage-gated K+ channel Kv1.3 in B cells in the lytic phase of KSHV, during which active viral replication occurs. KSHV increased the abundance and activity of Kv1.3 channels during lytic replication. Overexpression of the KSHV-encoded early protein RTA was sufficient to induce the transcription of Kv1.3-encoding mRNA. Kv1.3 maintained a hyperpolarized membrane potential that allowed Ca2+ influx, which was required for KSHV lytic replication. These results suggest that Kv1.3 is a potential target in treating KSHV-driven malignancies. —Amy E. Baek [ABSTRACT FROM AUTHOR]

Background: Cancer is becoming a major health problem in Uganda. Cancer control requires accurate estimates of the cancer burden for planning and monitoring of the cancer control strategies. However, cancer estimates and trends for Uganda are mainly based on one population-based cancer registry (PBCR), located in Kampala, the capital city, due to a lack of PBCRs in other regions. This study aimed at estimating cancer incidence among the geographical regions and providing national estimates of cancer incidence in Uganda. Methods: A retrospective study, using a catchment population approach, was conducted from June 2019 to February 2020. The study registered all newly diagnosed cancer cases, in the period of 2013 to 2017, among three geographical regions: Central, Western and Eastern regions. Utilizing regions as strata, stratified random sampling was used to select the study populations. Cases were coded according to the International Classification of Diseases for Oncology (ICD-0-03). Data was analysed using CanReg5 and Microsoft Excel. Results: 11598 cases (5157 males and 6441 females) were recorded. The overall national age-standardized incidence rates (ASIR) were 82.9 and 87.4 per 100,000 people in males and females respectively. The regional ASIRs were: 125.4 per 100,000 in males and 134.6 per 100,000 in females in central region; 58.2 per 100,000 in males and 56.5 per 100,000 in females in Western region; and 46.5 per 100,000 in males and 53.7 per 100,000 in females in Eastern region. Overall, the most common cancers in males over the study period were cancers of the prostate, oesophagus, Kaposi's sarcoma, stomach and liver. In females, the most frequent cancers were: cervix, breast, oesophagus, Kaposi's sarcoma and stomach. Conclusion: The overall cancer incidence rates from this study are different from the documented national estimates for Uganda. This emphasises the need to enhance the current methodologies for describing the country's cancer burden. Studies like this one are critical in enhancing the cancer surveillance system by estimating regional and national cancer incidence and allowing for the planning and monitoring of evidence-based cancer control strategies at all levels. [ABSTRACT FROM AUTHOR]

Introduction. According to the European Cancer Information System, melanoma is the sixth most diagnosed cancer in Europe (following breast, colorectal, prostate, lung, and bladder cancer) and ranks among the top 20 most common causes of cancer-related death. The diagnosis of melanoma can be a clinical challenge due to the variety of signs and symptoms, ranging from small, asymptomatic lesions with slow progression to large, painful tumors with rapid growth. In this paper, we will report an exceptional case of cutaneous melanoma with an atypical presentation in a patient with no personal or family history of skin cancer. Case presentation. We present the case of an 85-year-old patient who presented to our dermatology clinic with multiple nodular lesions on her right calf, extending to her thigh as isolated lesions. These violaceous lesions varied in size and displayed signs of bleeding, fibrin deposits, and purulent, foul-smelling discharge. The patient reported a fivemonth history of rapid tumor progression. The initial presumptive diagnosis was Kaposi's sarcoma; however, the biopsy ruled out this diagnosis, revealing the presence of malignant melanoma. Given the extensive locoregional spread and invasion of deep structures, the patient was transferred to palliative care. Conclusions. Melanoma is an aggressive form of cancer that can rapidly progress, often presenting with atypical clinical manifestations or mimicking other skin conditions. When the clinical presentation deviates from the classic patterns, a biopsy is considered the gold standard for guiding the clinician's subsequent approach. It provides valuable diagnostic information and aids in determining the prognosis as well as the appropriate therapeutic course. [ABSTRACT FROM AUTHOR]

This article explores the coexistence of lichen planus and vitiligo, two common skin conditions, in three patients. The lichenoid papules and plaques were found to develop on pre-existing vitiligo patches, with one patient experiencing them on sun-exposed areas and the other two exclusively on the dorsal hands. The diagnosis was confirmed through dermoscopy and histopathological examination. Treatment with mometasone furoate cream was effective for lichen planus, but the depigmented macules of vitiligo remained. The article suggests that sun damage in vitiligo patches may be the main cause, but other factors should be considered. [Extracted from the article]

Simple Summary: While sun exposure and associated tissue changes stemming from ultraviolet radiation are closely associated with the most common forms of skin cancer, far less is known regarding rare types of skin cancer. In this study, for the first time, we used a light microscopy technique to evaluate connective tissue changes in samples from patients with six different types of rare skin cancers, assessing the relationship between these changes, patient age, and whether tumors arose on sun-exposed parts of the body. We found that these tissue changes were most pronounced for patients with specific cancers known to be linked to chronic sun damage and tumors arising on sun-exposed parts of the body. We also noted tumor type-specific trends in terms of sex ratios, sites of tumor presentation, and the relationship between the development of particular tumors and patient immunosuppression. Our results are important and novel as they expand the available data associated with these rare skin cancers while also offering insight into the value of differentiating among these tumor types based on their relationship with sun exposure, potentially informing preventative, diagnostic, and/or therapeutic approaches. (1) Background: Rare skin cancers include epithelial, neuroendocrine, and hematopoietic neoplasias as well as cutaneous sarcomas. Ultraviolet (UV) radiation and sunburns are important drivers for the incidence of certain cutaneous sarcomas; however, the pathogenetic role of UV light is less clear in rare skin cancers compared to keratinocyte cancer and melanoma. In this study, we compared the degree of actinic elastosis (AE) as a surrogate for lifetime UV exposure among selected rare skin cancers (atypical fibroxanthoma [AFX], pleomorphic dermal sarcoma [PDS], dermatofibrosarcoma protuberans [DFSP], Kaposi sarcoma [KS], Merkel cell carcinoma [MCC], and leiomyosarcoma [LMS]) while taking into account relevant clinical variables (age, sex, and body site). (2) Methods: We newly established a semi-quantitative score for the degree of AE ranging from 0 = none to 3 = total loss of elastic fibers (basophilic degeneration) and multiplied it by the perilesional vertical extent (depth), measured histometrically (tumor-associated elastosis grade (TEG)). We matched the TEG of n = 210 rare skin cancers from 210 patients with their clinical variables. (3) Results: TEG values were correlated with age and whether tumors arose on UV-exposed body sites. TEG values were significantly higher in AFX and PDS cases compared to all other analyzed rare skin cancer types. As expected, TEG values were low in DFSP and KS, while MCC cases exhibited intermediate TEG values. (4) Conclusions: High cumulative UV exposure is more strongly associated with AFX/PDS and MCC than with other rare skin cancers. These important results expand the available data associated with rare skin cancers while also offering insight into the value of differentiating among these tumor types based on their relationship with sun exposure, potentially informing preventative, diagnostic and/or therapeutic approaches. [ABSTRACT FROM AUTHOR]

This article discusses a case of an adolescent male who presented with a solitary firm nodule on his upper back. The nodule was asymptomatic and had been present for four years. Despite receiving multiple treatments, the nodule did not improve. Dermoscopy and histopathology revealed features consistent with aneurysmal dermatofibroma (ADF), a rare variant of dermatofibroma. ADF can be mistaken for other malignancies and requires a high degree of suspicion for diagnosis. The nodule was surgically excised without recurrence. [Extracted from the article]

Kaposi sarcoma (KS) is a cancer originating from the endothelial cells of blood and lymphatic vessels. It develops multifocally as a result of pathological vascular hyperplasia. There are four forms of the disease: classic, endemic, iatrogenic, and epidemic. The treatment of Kaposi’s sarcoma depends on the clinical form, stage of advancement, and the immunological condition of the patient. The article presents the case of an 82-year-old patient from the Dermatology Department of the Provincial Hospital in Elblag diagnosed with Kaposi’s sarcoma with bullous lesions. [ABSTRACT FROM AUTHOR]

After liver transplantation (LTx), the most common cause of death in the long-term is de-novo malignancy (DNM). The aim is to review the gender differences in the standardized incidence ratio (SIR) of DNM within the same geographical locations. Four studies were identified comparing post-LTx SIR between males and females. From 6663 males and 2780 females LTx recipients, the mean SIR from each of the four studies for males is 2.8, 2.0, 1.94, and 3.4, and 3.5, 1.3, 1.95, and 2.3 for females. On meta-analysis using a random effect model for each gender group. No significant difference was revealed after logarithmic transformation and subgroup meta-analysis. Overall mean SIR with 95% Confidence Interval (CI) for males is 2.53 (95% CI 1.65-3.88) and 2.3 (1.25-4.24) for females. lung malignancy, 1.97 (1.14-3.41) for males and 2.65 (0.67-10.47) for females. For colorectal malignancy, the combined SIR for males is 1.98 (0.58-6.78) and 1.85 (1.02-3.37) for females. The SIR for female gender-specific malignancies; SIR for breast is 1.1 ± 4.4, cervix 2.9 ± 1.9, uterus 2.8, and ovarian 0.7, and for males, testis 1.6 ± 1.3, prostate 1.2 ± 0.4. However, rare malignancies, male breast cancers (n = 1, SIR, 22.6), and Kaposi's sarcoma, in males (n = 6) and in females (n = 1), had SIR 120. and 212.7, respectively. Overall, there are no statistical differences between male and female DNM. Female-specific cervix, uterus, ovarian, and male-specific testis and prostate have similar SIR. Rare malignancies have very high SIR. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: We aim to enhance the understanding of soft tissue sarcomas (STS) within the Saudi population, guiding better diagnosis, treatment strategies, and healthcare resource allocation for this rare but challenging cancer type. Methods: Retrospective data of 160 patients at King Abdulaziz University Hospital (2013--2023) were examined for demographics, anatomical sites, and diagnoses of STS. Statistical analysis in RStudio (R v4.3.1) utilized Fisher's exact and chi-squared tests for categorical variables (P < 0.05), while continuous variables were summarized by medians and interquartile range. Results: We included patients with STS, evenly split between males and females (median age: 47 years) Significant differences were observed between age groups: younger patients (<50 years) more commonly had rhabdomyosarcoma and synovial sarcoma, while older patients (≥50 years) showed higher rates of dedifferentiated liposarcoma, Kaposi sarcoma, and leiomyosarcoma. Sarcoma locations varied, with the thigh, retroperitoneum, and head and neck being prominent sites. Higher frequencies of Kaposi sarcoma and skin sarcomas were noted in males, and leiomyosarcoma and uterine sarcomas exclusively in females. Conclusion: The study highlights significant sex and age disparities in the diagnosis and distribution of STS among Saudi patients. Rhabdomyosarcoma emerges as the most frequent subtype, influenced by factors such as genetic predisposition and advanced diagnostic capabilities. Understanding these demographic variations is crucial for developing targeted treatment strategies tailored to the unique needs of different patient groups. Further research into the underlying biological and environmental factors driving these disparities is essential for advancing sarcoma care and improving patient outcomes in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Head and neck cancers (HNCs) constitute a wide range of malignancies originating from the epithelial lining of the upper aerodigestive tract, including the oral cavity, pharynx, larynx, nasal cavity, paranasal sinuses, and salivary glands. Although lymphomas affecting this region are not conventionally classified as HNCs, they may occur in lymph nodes or mucosa-associated lymphoid tissues within the head and neck. Oncogenic viruses play a crucial role in HNC onset. Human papillomavirus (HPV) is extensively studied for its association with oropharyngeal cancers; nevertheless, other oncogenic viruses also contribute to HNC development. This review provides an overview of the epidemiology, pathogenesis, and advancements in detection methods of oncogenic viruses associated with HNCs, recognizing HPV's well-established role while exploring additional viral connections. Notably, Epstein–Barr virus is linked to nasopharyngeal carcinoma and lymphomas. Human herpesvirus 8 is implicated in Kaposi's sarcoma, and Merkel cell polyomavirus is associated with subsets of HNCs. Additionally, hepatitis viruses are examined for their potential association with HNCs. Understanding the viral contributions in the head and neck area is critical for refining therapeutic approaches. This review underlines the interaction between viruses and malignancies in this region, highlighting the necessity for ongoing research to elucidate additional mechanisms and enhance clinical outcomes. [ABSTRACT FROM AUTHOR]

The article explores the expression of programmed cell death proteins in patients with atypical fibroxanthoma and pleomorphic dermal sarcoma, indicating their potential for anti-PD-1/PD-L1 therapy. The study analyzed tissue samples from patients and found higher PD-L1 expression in pleomorphic dermal sarcoma compared to atypical fibroxanthoma. The research suggests that immunotherapeutic interventions may be more relevant for pleomorphic dermal sarcoma due to its higher rate of metastases. The findings also highlight the association of tumor thickness with disease relapse and survival in these types of skin cancers. [Extracted from the article]