Sage Journals: Discover world-class research

Abstract

The increasing appearance of AIDS-associated oral Kaposi’s sarcoma (KS) in South Africa may be ascribed to the later start of the HIV epidemic, more patients reaching stages III and IV, and the inaccessibility of most patients to anti-retroviral therapy. The objective of this study was to demonstrate cytomegalovirus (CMV) co-infection in oral KS and to consider its possible significance. We reviewed 20 cases of oral KS in known HIV-positive patients without active CMV disease. HHV8 PCR and CMV immunohistochemistry were performed. HHV8 DNA was present in all cases. CMV inclusions were detected in five cases. The significance of CMV co-infection in oral KS is unclear. The inclusions suggest active infection, although there is no evidence to support CMV in the pathogenesis of KS. Nonetheless, it is vital that physicians be alerted to active CMV infection, so that timely intervention and careful observation can be instituted, ensuring early diagnosis and treatment.

Get full access to this article

View all access options for this article.

References

Biggar RJ, Rabkin CS (1996). The epidemiology of AIDS-related neoplasms. Hematol Oncol Clin North Am 10:997–1010.

Cohen RL, Tepper RE, Urmacher C, Katz S (2001). Kaposi’s sarcoma and cytomegaloviral ileocolitis complicating long-standing Crohn’s disease in an HIV negative patient. Am J Gastroenterol 96:3028–3031.

Dorrington R, Bradshaw D, Budlender D, Bourne D (2002). The current state and future projections of the HIV/AIDS epidemic in South Africa. S Afr Dent J 57:449–450.

Flaitz CM, Nichols CM, Hicks MJ (1995). An overview of the oral manifestations of AIDS-related Kaposi’s sarcoma. Compend Contin Educ Dent 16:136–142.

Flaitz CM, Nichols CM, Hicks MJ (1996). Herpesviridae-associated persistent mucocutaneous ulcers in acquired immunodeficiency syndrome. A clinicopathologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 81:433–441.

Glassman SJ, Hale MJ (1995). Cutaneous cryptococcosis and Kaposi’s sarcoma occurring in the same lesions in a patient with the acquired immunodeficiency syndrome. Clin Exp Dermatol 20:480–486.

Hille JJ, Webster-Cyriaque J, Palefski JM, Raab-Traub N (2002). Mechanisms of expression of HHV8, EBV and HPV in selected HIV-associated oral lesions. Oral Dis 8(Suppl 2):161–168.

Ives NJ, Gazzard BG, Easterbrook PJ (2001). The changing pattern of AIDS-defining illnesses with the introduction of highly active antiretroviral therapy (HAART) in a London clinic. J Infect 42:134–139.

Kempf W, Adams V (1996). Viruses in the pathogenesis of Kaposi’s sarcoma—a review. Biochem Mol Med 58:1–12.

10.

Kempf W, Adams V, Pfaltz M, Briner J, Schmid M, Moos R, et al. (1995). Human herpesvirus type 6 and cytomegalovirus in AIDS-associated Kaposi’s sarcoma: no evidence for an etiological association. Hum Pathol 26:914–919.

11.

Lager I, Altini M, Coleman H, Ali H (2003). Oral Kaposi’s sarcoma: a clinicopathologic study from South Africa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:701–710.

12.

Lundgren JD, Melbye M, Pedersen C, Rosenberg PS, Gerstoft J (1995). Changing patterns of Kaposi’s sarcoma in Danish acquired immunodeficiency syndrome patients with complete follow-up. The Danish Study Group for HIV infection (DASHI). Am J Epidemiol 141:652–658.

13.

Moysset I, Lloreta J, Miguel A, Vadell C, Ribalta T, Estrach T, et al. (1997). Thymoma associated with CD4+ lymphopenia, cytomegalovirus infection, and Kaposi’s sarcoma. Hum Pathol 28:1211–1213.

14.

Said JW, Chien K, Tasaka T, Koeffler HP (1997). Ultrastructural characterization of human herpesvirus 8 (Kaposi’s sarcoma-associated herpesvirus) in Kaposi’s sarcoma lesions: electron microscopy permits distinction from cytomegalovirus (CMV). J Pathol 182:273–281.

15.

Sitas F, Newton R (2001). Kaposi’s sarcoma in South Africa. J Natl Cancer Inst Monogr 28:1–4.

16.

Syrjänen S, Leimola-Virtanen R, Schmidt-Westhausen A, Reichart PA (1999). Oral ulcers in AIDS patients frequently associated with cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections. J Oral Pathol Med 28:204–209.

17.

Zhang X, el-Sahrigy D, Elhosseiny A, Melamed MR (2003). Simultaneous cytomegalovirus infection and Kaposi’s sarcoma of the thyroid diagnosed by fine needle aspiration in an AIDS patient. A case report and first cytologic description of the two entities occurring together. Acta Cytol 47:645–648.

Cytomegalovirus Co-infection in AIDS-associated Oral Kaposi’s Sarcoma

Abstract

Get full access to this article

References