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Kaposi Sarcoma-Associated Herpesvirus Risk and Disease in Kidney Donors and Transplant Recipients with HIV in the United States

  1. Author:
    Nambiar, Puja
    Liang, Tao [ORCID]
    Labo,Maria Nazzarena [ORCID]
    Hand, Jonathan [ORCID]
    Blumberg, Emily A [ORCID]
    Rana, Meenakshi M
    Florman, Sander
    Haydel, Brandy [ORCID]
    Morris, Michele I [ORCID]
    Schaenman, Joanna
    Rodrigues, Moreno M S
    Werbel, William A [ORCID]
    Bowring, Mary G
    Friedman-Moraco, Rachel J
    Stock, Peter
    Stosor, Valentina [ORCID]
    Mehta, Shikha
    Gilbert, Alexander J [ORCID]
    Elias, Nahel [ORCID]
    Mehta, Sapna A
    Small, Catherine B
    Haidar, Ghady
    Malinis, Maricar [ORCID]
    Pereira, Marcus R
    Aslam, Saima
    Wojciechowski, David [ORCID]
    La Hoz, Ricardo [ORCID]
    Santos, Carlos A Q [ORCID]
    Apewokin, Senu
    Castillo-Lugo, Jose A
    Ranganna, Karthik
    Morsheimer, Megan
    Massie, Allan [ORCID]
    Segev, Dorry L [ORCID]
    Miley,Wendell
    Marshall,Vickie [ORCID]
    Whitby,Denise [ORCID]
    Tobian, Aaron A A
    Durand, Christine M [ORCID]

  2. Author Address

    Memorial Sloan Kettering Cancer Center, NY, NY, USA., Johns Hopkins University School of Medicine, Baltimore, MD, USA., Frederick National Laboratory for Cancer Research, Frederick, MD, USA., Ochsner Health, New Orleans, LA, USA., Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA., Icahn School of Medicine at Mount Sinai, New York, NY, USA., Recanati-Miller Transplantation Institute, The Mount Sinai Hospital, New York, NY, USA., University of Miami Miller School of Medicine, Miami, FL, USA., David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Emory University, Atlanta, GA, USA., University of California, San Francisco, San Francisco, CA, USA., Northwestern University Feinberg School of Medicine, Chicago, IL, USA., University of Alabama at Birmingham, Birmingham, AL, USA., Georgetown University, Washington D.C., USA., Massachusetts General Hospital, Boston, MA, USA., NYU Langone Transplant Institute, New York, NY, USA., Weill Cornell Medicine, New York, NY, USA., University of Pittsburgh, Pittsburgh, PA, USA., Yale School of Medicine, New Haven, CT, USA., Columbia University Irving Medical Center, New York, NY, USA., University of California San Diego, La Jolla, CA, USA., UT Southwestern Medical Center, Dallas, TX, USA., Rush University Medical Center, Chicago, IL, USA., University of Cincinnati College of Medicine, Cincinnati, OH, USA., Methodist Health System Clinical Research Institute, Dallas, TX, USA., Drexel University College of Medicine, Philadelphia, PA, USA., National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA.,
    1. Year: 2025
    2. Date: May 05
    3. Epub Date: 2025 05 05
  2. Journal: Clinical Infectious Diseases : an official publication of the Infectious Diseases Society of America
  4. Type of Article: Article
  5. Article Number: ciaf229
  1. Abstract:

    Due to high prevalence of Kaposi Sarcoma (KS)-Associated Herpesvirus (KSHV) among people with HIV, KSHV-associated disease (KAD) may be increased after kidney transplantation from donors with HIV (HIV D+) to recipients with HIV (HIV R+). Anti-KSHV antibodies were measured in HIV R+ and donors with and without HIV (HIV D-) using a 30-antigen multiplex assay within three 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 post-transplant anti-KSHV antibody changes and KAD. 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) 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 0.26-1.52): 3 skin-only KS, 1 multicentric Castleman disease, 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. 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 Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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External Sources

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  2. DOI: 10.1093/cid/ciaf229
  3. PMID: 40324947
  4. PII : 8125479

Library Notes

  1. Fiscal Year: FY2024-2025
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