Archives of Hellenic Medicine

Last update:

11-Nov-2004

Arch Hellen Med, 21(3), May-June 2004, 267-273

ORIGINAL PAPER

Is there correlation between the severity of upper gastrointestinal bleeding
and Helicobacter pylori infection or the prior use of NSAIDs?

G. ZAVOS,¹ Ι. PAPACONSTANTINOU,¹ M. GAZOULI,² V. METAXA-MARIATOU,³
I. BOKOS,¹ P. ARAPANTONI-DADIOTI,⁴ K. GIASLAKIOTIS,⁵ G. NASIOULAS,³ A. KOSTAKIS¹
¹Transplantation Department, “Laiko” General Hospital, Athens
²Department of Histology-Embryology, School of Medicine, University of Athens, Athens
³Molecular Biology Research Center, “Hygeia” Hospital- “Antonis Papayiannis”, Athens
⁴Department of Pathology, “Metaxa” Anti-Cancer Hospital, Piraeus
⁵Department of Pathology, “Laiko” General Hospital, Athens, Greece

OBJECTIVE The incidence of Kaposi’s sarcoma (KS) in renal transplant recipients is significantly greater than that in the general population. It is still unclear whether post-transplant KS is due to reactivation of HHV-8 as result of immunosuppressive treatment or to primary HHV-8 infection transmitted via organ transplantation. The goals of the present study were assessment of the association of HHV-8 with KS developing in Greek renal transplant recipients and HHV-8 characterization, by subtyping of the ORF-26 and ORF-K1 genomic regions.

METHOD Blood or tissue samples from transplant recipients with and without KS were examined. As controls, samples from classic KS patients, AIDS-associated KS patients and healthy individuals were examined in parallel. The ΗΗV-8 detection was performed by nested-PCR, and confirmed by nucleotide sequencing of the PCR products. The genotyping of HHV-8 isolates was carried out by nucleotide sequencing of specific variable regions of ORF-26 and ORF-K1.

RESULTS Of 1055 patients who received renal transplants during the last 18 years, KS was encountered in 18 (1.7%). HHV-8 DNA was detected in 93.3% of KS transplant recipients and in 10% of transplant recipients without KS. HHV-8 DNA was found in all cases of patients with classic and AIDS-associated KS and in 16.7% of healthy individuals tested. Concerning the genotype, the findings imply a possible link with the C3 subtype of HHV-8 in renal-transplant related KS cases, a possible link with the A4 subtype in AIDS-associated KS cases and a potential involvement of the A1 subtype in Greek classic KS cases, as HHV-8 strains among healthy individuals tested belong to the C1, C3 or A1 subtypes.

CONCLUSIONS Kaposi’s sarcoma presented with an incidence of 1.7% after renal transplantation in this study. A possible link with the C3 subtype of HHV-8 was identified in renal-transplant related KS cases.

Key words: HHV-8, Kaposi’s sarcoma, Renal transplantation.