Journal article
Kaposi Sarcoma-Associated Herpesvirus Risk and Disease in Kidney Donors and Transplant Recipients With HIV in the United States
Clinical infectious diseases, v 82(4), pp 709-719
30 Apr 2026
PMID: 40324947
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Due to high prevalence of Kaposi sarcoma-associated herpesvirus (KSHV) among people with human immunodeficiency virus (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 3 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 posttransplant 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) status 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, .26-1.52]): 3 skin-only Kaposi sarcoma (KS), 1 multicentric Castleman disease, and 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.
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Details
- Title
- Kaposi Sarcoma-Associated Herpesvirus Risk and Disease in Kidney Donors and Transplant Recipients With HIV in the United States
- Creators
- Puja H Nambiar - Memorial Sloan Kettering Cancer CenterTao Liang - National Institute of Allergy and Infectious DiseasesNazzarena Labo - Frederick National Laboratory for Cancer ResearchJonathan Hand - The University of QueenslandEmily A Blumberg - University of PennsylvaniaMeenakshi M Rana - National Institute of Allergy and Infectious DiseasesSander Florman - National Institute of Allergy and Infectious DiseasesBrandy Haydel - Mount Sinai HospitalMichele I Morris - University of Miami HospitalJoanna Schaenman - University of California, Los AngelesMoreno M S Rodrigues - Johns Hopkins University School of MedicineWilliam A Werbel - Johns Hopkins MedicineMary G Bowring - Johns Hopkins MedicineRachel J Friedman-Moraco - Emory UniversityPeter Stock - University of California, San FranciscoValentina Stosor - Northwestern UniversityShikha Mehta - National Institute of Allergy and Infectious DiseasesAlexander J Gilbert - National Institute of Allergy and Infectious DiseasesNahel Elias - National Institute of Allergy and Infectious DiseasesSapna A Mehta - NYU Langone HealthCatherine B Small - Cornell UniversityGhady Haidar - National Institute of Allergy and Infectious DiseasesMaricar Malinis - National Institute of Allergy and Infectious DiseasesMarcus R Pereira - National Institute of Allergy and Infectious DiseasesSaima Aslam - National Institute of Allergy and Infectious DiseasesDavid Wojciechowski - National Institute of Allergy and Infectious DiseasesRicardo La Hoz - The University of Texas Southwestern Medical CenterCarlos A Q Santos - Rush University Medical CenterSenu Apewokin - National Institute of Allergy and Infectious DiseasesJose A Castillo-Lugo - Mount Sinai HospitalKarthik Ranganna - Drexel University, Medicine (Graduate)Megan Morsheimer - National Institute of Allergy and Infectious DiseasesAllan Massie - National Institute of Allergy and Infectious DiseasesDorry L Segev - New York UniversityWendell Miley - Frederick National Laboratory for Cancer ResearchVickie Marshall - Frederick National Laboratory for Cancer ResearchDenise Whitby - Frederick National Laboratory for Cancer ResearchAaron A A Tobian - Johns Hopkins University School of MedicineChristine M Durand - National Institute of Allergy and Infectious Diseases
- Publication Details
- Clinical infectious diseases, v 82(4), pp 709-719
- Publisher
- Oxford University Press
- Number of pages
- 11
- Grant note
- U01 AI138897 / NIAID NIH HHS R01AI120938 / NIH HHS U01AI177211 / NIH HHS 75N91024F00011 / The Living Legacy Foundation U01 AI177211 / NIAID NIH HHS R01 DK131926 / NIDDK NIH HHS U01 AI138897 / NIH HHS K23AI157893 / NIH HHS P30 CA008748 / NCI NIH HHS K23 AI157893 / NIAID NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate)
- Web of Science ID
- WOS:001498885000001
- Scopus ID
- 2-s2.0-105010511942
- Other Identifier
- 991022051419504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Microbiology