Human Herpesvirus-8 Antibody, IgG, Serum
Assessment of serostatus of organ transplant patients to Human Herpesvirus-8 before a procedure to evaluate risk for transmission of virus and subsequent development of Kaposi's sarcoma
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Human herpesvirus-8 (HHV-8) infections are limited in the general population. The virus was first discovered in Kaposi's sarcoma (KS) lesions and also is known as Kaposi's sarcoma herpesvirus.(1)
Endemic KS is common in sub-Saharan equatorial Africa, accounting for 10% to 17% of all adult malignancies. Elsewhere KS is rare, occurring primarily in Mediterranean and Eastern European adults. In the United States, KS primarily affects acquired immunodeficiency syndrome (AIDS) patients. Approximately 90% of KS tissues from AIDS patients contain HHV-8 DNA sequences. Sexual transmission of human herpesvirus-8 (HHV-8) may be possible since HHV-8 DNA sequences have been found in the semen of AIDS patients.
HHV-8 also is associated with transplantation-associated KS, which occurs in up to 5% of kidney transplant patients. Transmission of HHV-8 through renal allografts has been shown to be a risk factor for transplantation-associated KS.(3,6) Patients who are negative for antibodies to HHV-8 and receive transplanted organs from a donor who has antibodies to HHV-8 are at increased risk for the development of KS post transplantation.
HHV-8 also is associated with Bowenâ€™s disease, a malignant squamous cell carcinoma; primary effusion lymphoma; Castleman's disease; and multiple myeloma.(1,4,5)
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative (reported as positive or negative)
The IgG antibody seroprevalence rate in the normal population has not been established due to the fact that the human herpesvirus-8 (HHV-8) virus was only recently discovered. Data suggests that the seroprevalence rate in the general population is 5% to 28%.
HHV-8 IgG antibody titers of <1:40 in the immunofluorescent assay are considered negative.
A positive result indicates the presence of IgG class antibodies to HHV-8; the individual has been infected with this virus sometime in the past.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A serum specimen drawn during the acute phase of infection when only low levels of IgG are present may be negative by this procedure.
Patients with autoimmune diseases can have non specific positive reactions.
Regamey et al. (6) found that among 220 renal transplant recipients-6.4% of whom were seropositive for antibodies to human herpesvirus-8 on the day of transplantation- 25 seroconverted within 1 year after transplantation. Kaposi's sarcoma developed in 2 of these patients. No cases of KS were detected among the 6.4% of patients (14/220) who were seropositive before transplantation and in whom the infection could have been reactivated after transplantation.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Chang Y, Cesarman E, Pessin MS, et al: Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma. Science 1994;266:1865-1869
2. Belec L, Authier FJ, Mohamed AS, et al: Antibodies to human herpesvirus 8 in POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome with multicentric Castleman's disease. Clin Infect Dis 1999;28:678-679
3. Koelle DM, Huang ML, Chandran B, et al: Frequent detection of Kaposi's sarcoma-associated herpesvirus (human herpesvirus 8) DNA in saliva of human immunodeficiency virus-infected men: clinical and immunologic correlates. J Infect Dis 1997;176:94-102
4. Oksenhendler E, Cazals-Hatem D, Schulz TF, et al: Transient angiolymphoid hyperplasia and Kaposi's sarcoma after primary infection with human herpesvirus 8 in a patient with human immunodeficiency virus infection. N Engl J Med 1998;338:1585-1590
5. Frances C, Mouquet C, Calvez V: Human herpesvirus 8 and renal transplantation. N Engl J Med 1999;340: 1045-1046
6. Regamey N, Tamm M, Wernli M, et al: Transmission of human herpesvirus 8 infection from renal-transplant donors to recipients. N Engl J Med 1998;339:1358-1363