Kaposi Sarcoma-Associated Herpesvirus Risk and Disease in Kidney Donors and Transplant Recipients With Human Immunodeficiency Virus in the United States Journal Article

  

Authors:	Nambiar, P. H.; Liang, T.; Labo, N.; Hand, J.; Blumberg, E. A.; Rana, M. M.; Florman, S.; Haydel, B.; Morris, M.; Schaenman, J.; Rodrigues, M. M. S.; Werbel, W. A.; Bowring, M. G.; Friedman-Moraco, R. J.; Stock, P.; Stosor, V.; Mehta, S.; Gilbert, A. J.; Elias, N.; Mehta, S. A.; Small, C. B.; Haidar, G.; Malinis, M.; Pereira, M. R.; Aslam, S.; Wojciechowski, D.; La Hoz, R.; Santos, C. A. Q.; Apewokin, S.; Castillo-Lugo, J. A.; Ranganna, K.; Morsheimer, M.; Massie, A.; Segev, D. L.; Miley, W.; Marshall, V.; Whitby, D.; Tobian, A. A. A.; Durand, C. M.
Article Title:	Kaposi Sarcoma-Associated Herpesvirus Risk and Disease in Kidney Donors and Transplant Recipients With Human Immunodeficiency Virus in the United States
Abstract:	Background Due to high prevalence of Kaposi sarcoma-associated herpesvirus (KSHV) among people with human immunodeficiency virus (HIV), KSHV-associated disease (KAD) may be increased after kidney transplantation from donors with HIV (HIV D+) to recipients with HIV (HIV R+).Methods Anti-KSHV antibodies were measured in HIV R+ and donors with and without HIV (HIV D-) using a 30-antigen multiplex assay within 3 multicenter kidney transplantation studies. KSHV seropositivity was defined as reactivity to conventional KSHV antigens (>= 1 ORF73 or K8.1); reactivity to expanded 5-antigen and 30-antigen panels were also reported. Risk factors were identified using modified Poisson regression. Recipients were monitored for posttransplant anti-KSHV antibody changes and KAD.Results KSHV seroprevalence was 40.6% (143/352) among HIV R+, 25.2% (33/131) among HIV D+, and 7.5% (4/53) among HIV D-. In the multivariable model, only men who have sex with men (MSM) status was associated with KSHV seropositivity (relative risk, 1.51 [95% confidence interval {CI}, 1.07-2.14] in recipients and 2.39 [95% CI, 1.03-5.53] in donors). Among 418 HIV R+ (215 HIV D+/R+, 203 HIV D-/R+), there were 5 KAD cases (incidence, 0.63 cases/100 person-years [95% CI, .26-1.52]): 3 skin-only Kaposi sarcoma (KS), 1 multicentric Castleman disease, and 1 allograft KS. The allograft KS occurred in a female HIV D+/R+ and was likely donor derived. Remaining KAD cases occurred in male HIV D-/R+ and were likely recipient KSHV reactivation or acquisition.Conclusions In the United States, KSHV seroprevalence in donors and recipients with HIV was high, particularly among MSM. Reassuringly, KSHV-associated disease was rare and primarily attributed to recipient rather than donor-derived KSHV. The prevalence of Kaposi sarcoma-associated herpesvirus (KSHV) was high among kidney donor and transplant recipients with HIV. Posttransplant KSHV-associated disease incidence was similar to that observed in endemic countries but disease was generally mild and attributed to recipient KSHV.
Keywords:	prevalence; liver; kaposi sarcoma; antibodies; epidemiology; human herpesvirus 8; hiv; valganciclovir; men; human-herpesvirus-8 infection; seroprevalence; sexual transmission; hope act; kshv seroprevalence
Journal Title:	Clinical Infectious Diseases
ISSN:	1058-4838
Publisher:	Oxford University Press
Publication status:	Online ahead of print
Date Published:	2025-01-01
Online Publication Date:	2025-01-01
Language:	English
ACCESSION:	WOS:001498885000001
DOI:	10.1093/cid/ciaf229
PROVIDER:	wos
Notes:	Article; Early Access -- Source: Wos

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