Metastatic Kaposi Sarcoma
Kaposi sarcoma (KS) is a distinctive type of vascular neoplasm that can involve any anatomic site and it is virtually always associated with human herpes virus-8 (HHV8) infection. HHV8, also known as Kaposi sarcoma-associated herpes virus, is uniformly expressed in KS lesions. The virus is distributed worldwide and the prevalence in the general population is variable, being highest in sub-Saharan Africa where more than 40 % of the population is infected. Seropositivity for HHV8 is less than 10 % in United States, northern Europe, and certain countries of Asia. The virus is transmitted via sexual or nonsexual routes. Infection with HHV8 is not sufficient to trigger KS, and other factors are involved in the pathogenesis including angiogenic factors, cytokines, and viral proteins expressed during latent and lytic phases of the viral life cycle. HHV8 likely infects progenitor cells of either blood vessel or lymphatic endothelium and usually establishes a latent infection. Kaposi sarcoma most often arises in the setting of immunodeficiency and particularly human immunodeficiency virus (HIV) infection. In patients with HIV, the transactivator of transcription (TAT) protein has mitogenic and modulating effects on KS cells and thus has a pathogenic role in these patients.
KeywordsHuman Immunodeficiency Virus Human Immunodeficiency Virus Infection Germinal Center Viral Life Cycle Lymphatic Endothelium
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