Kaposi’s Sarcoma-Associated Herpesvirus
Kaposi’s Sarcoma-Associated Herpesvirus
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DOI：
10.1128/9781555815981.ch25
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
P. Moore;Yuan Chang
中科院分区：
文献类型：
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作者：
P. Moore;Yuan Chang
卡波西肉瘤相关疱疹病毒(KSHV)，又称人类疱疹病毒8(HHV-8)，是一种大型双链DNA疱疹病毒，可引起卡波西肉瘤(KS)以及一些恶性和增生性淋巴系统疾病。KSHV也以潜伏病毒的形式存在于感染细胞中。与裂解复制相反，潜伏的病毒基因表达提供了抑制细胞过早死亡的增殖和生存因子。裂解复制的启动始于高度编排的基因表达级联，它决定了导致线性基因组复制、病毒粒子合成、基因组包装和病毒从感染细胞中排出的事件的序列。虽然在引入有效的抗逆转录病毒治疗后，与艾滋病相关的KS的发病率下降了70%至90%，但这些药物并不能抑制KSHV感染，据报道，在艾滋病毒载量较低和CD4+细胞计数较高的人中再次出现KS。虽然KSHV通过输血的传播性很差，但输血传播是可能发生的，并可能导致无声传播和疾病。对艾滋病患者队列的研究表明，KS可在初次感染后几周或几个月内发生，其中一例HIV阳性男子在感染后立即出现一过性血管淋巴样增生，并伴有KS梭形细胞的显微镜病灶。大多数Castleman病是透明血管变异型，表现为典型的纵隔或腹膜后的孤立性淋巴结增生。在艾滋病患者中，对KS最有效的控制措施是有效的抗逆转录病毒治疗。在接受高效抗逆转录病毒治疗的人中，KS的新诊断率明显较低。
Kaposi’s sarcoma-associated herpesvirus (KSHV), also called human herpesvirus 8 (HHV-8), is a large double-stranded DNA herpesvirus that causes Kaposi’s sarcoma (KS) as well as some malignant and hyperplastic lymphoid disorders. KSHV also resides as a latent virus in infected cells. In contrast to lytic replication, latent viral gene expression provides proliferation and survival factors that inhibit premature cell death. Initiation of lytic replication begins with a highly choreographed cascade of gene expression that determines the sequence of events leading to linear genome replication, virion synthesis, genome packaging, and egress of the virus from the infected cell. Although the incidence of AIDS-associated KS declined 70 to 90% after the introduction of effective antiretroviral therapy, these drugs do not inhibit KSHV infection, and a second emergence of KS among persons with low HIV loads and high CD4+ cell counts has been reported. Although KSHV is poorly transmissible through transfusion, transfusion transmission can occur and may cause silent transmission and disease. Studies of AIDS patient cohorts show that KS can develop within weeks or months of primary infection, and in one case, an HIV-positive man developed transient angiolymphoid hyperplasia with microscopic foci of KS spindle cells immediately after infection. The majority of Castleman’s disease is of the hyaline-vascular variant, which presents as solitary lymph node hyperplasia typically in the mediastinum or retroperitoneum. Among AIDS patients, the most effective control measure for KS is effective antiretroviral therapy. The rate of new KS diagnoses is markedly lower among persons on highly effective antiretroviral therapy.