Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2025
HHV8-related diseases in solid organ transplantation: a case series and systematic literature review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Bonazzetti Cecilia, Rinaldi Matteo, Giovagnorio Federico, İrkören Pelin, Casarini Martina, Cascavilla Alessandra, Morelli Maria Cristina, Vizioli Luca, Pianta Paolo, Comai Giorgia, Ravaioli Matteo, Potena Luciano, Gabrielli Liliana, Lazzarotto Tiziana, Alvaro Nicola, Viale Pierluigi, Giannella Maddalena
Аннотация
BACKGROUND: The true burden of HHV-8 in solid organ transplant (SOT) setting remains difficult to quantify and there are several uncertainties about the best prevention and management of HHV-8 related complications.
OBJECTIVES: To describe epidemiology and impact on outcome of HHV-8 related diseases in patients undergoing SOT, we reviewed all episodes diagnosed at our hospital over 8-year period and performed a narrative systematic literature review.
SOURCES: A search on PubMed, Scopus and Cochrane Library, according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, was done. All types of studies, published in any language from January 2000 to January 2025, focused on HHV-8 related diseases in adult and paediatric SOT recipients were considered. Due to heterogeneity among studies, the evidence synthesis was descriptive.
CONTENT: Ninety-one studies conducted across 26 countries were included. Overall, 337 HHV-8 cases were reported among 19,283 transplant recipients, including 215 (63.8%) kidney, 80 (23.7%) liver, 22 (6.5%) lung, 13 (3.9%) heart and 5 (1.5%) combined transplants. Considering only cohort studies, a prevalence of 1.1% was estimated. The median time from transplant to disease was 11 months. For cases with available data, mismatch D+/R- was common (41/63, 65.1%). Main diseases included cutaneous Kaposi Sarcoma (KS) (49.7%) and visceral KS (33.4%), Kaposi Sarcoma Inflammatory Cytokine Syndrome (KICS) accounted for 4.7%. Management of immunosuppressive regimens mostly consisted in in reduction of maintenance regimen (169/209, 80.9%) and switch from tacrolimus to mTOR (79/209, 37.9%). Twenty-five studies reported antiviral use in 48/70 (68.6%) patients consisting in ganciclovir/valganciclovir (21 cases), foscarnet (17 cases) and/or cidofovir (10 cases). Rituximab was used for both oncological and non-oncological HHV-8 related diseases. Overall, 90-day mortality was 19.7%, reaching 29% excluding cutaneous KS.
IMPLICATIONS: HHV-8 related diseases after SOT are relatively uncommon, but associated with high mortality rates. Standardized management protocols for HHV-8 diseases are needed.
OBJECTIVES: To describe epidemiology and impact on outcome of HHV-8 related diseases in patients undergoing SOT, we reviewed all episodes diagnosed at our hospital over 8-year period and performed a narrative systematic literature review.
SOURCES: A search on PubMed, Scopus and Cochrane Library, according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, was done. All types of studies, published in any language from January 2000 to January 2025, focused on HHV-8 related diseases in adult and paediatric SOT recipients were considered. Due to heterogeneity among studies, the evidence synthesis was descriptive.
CONTENT: Ninety-one studies conducted across 26 countries were included. Overall, 337 HHV-8 cases were reported among 19,283 transplant recipients, including 215 (63.8%) kidney, 80 (23.7%) liver, 22 (6.5%) lung, 13 (3.9%) heart and 5 (1.5%) combined transplants. Considering only cohort studies, a prevalence of 1.1% was estimated. The median time from transplant to disease was 11 months. For cases with available data, mismatch D+/R- was common (41/63, 65.1%). Main diseases included cutaneous Kaposi Sarcoma (KS) (49.7%) and visceral KS (33.4%), Kaposi Sarcoma Inflammatory Cytokine Syndrome (KICS) accounted for 4.7%. Management of immunosuppressive regimens mostly consisted in in reduction of maintenance regimen (169/209, 80.9%) and switch from tacrolimus to mTOR (79/209, 37.9%). Twenty-five studies reported antiviral use in 48/70 (68.6%) patients consisting in ganciclovir/valganciclovir (21 cases), foscarnet (17 cases) and/or cidofovir (10 cases). Rituximab was used for both oncological and non-oncological HHV-8 related diseases. Overall, 90-day mortality was 19.7%, reaching 29% excluding cutaneous KS.
IMPLICATIONS: HHV-8 related diseases after SOT are relatively uncommon, but associated with high mortality rates. Standardized management protocols for HHV-8 diseases are needed.