Kaposi's sarcoma-associated herpesvirus (KSHV) infection: Endemic strains and cladograms from immunodeficient patients in China

Abstract

Background The epidemiology and strain features of Kaposi's sarcoma-associated herpesvirus (KSHV) in transplant recipients and HIV-infected patients in China is not well described. Objectives To determine KSHV seroprevalence and characterize strains of KSHV in transplant recipients and HIV-infected patients in China. Methods Patients were screened for KSHV infection using a KSHV open reading frame (ORF) 65 recombinant protein-dependent ELISA. The 172 bp fragment of KSHV ORF26 was amplified by nested PCR and bilaterally sequenced from KSHV-seropositive peripheral blood mononuclear cells. ORF26 gene diversity and cladograms were analyzed and compared to predominant international strains. Results KSHV seroprevalence in renal transplant recipients [41% (44/107)] and HIV-infected patients [39% (29/74)] were significantly higher than in healthy people [13% (16/122)] ( P < 0.01), but KSHV seroprevalence in liver transplant recipients [15% (5/33)] was similar to that of healthy people ( P > 0.05). ORF26 DNA was detected in 47% (23/49) of KSHV-seropositive organ transplant recipients; 28% (8/29) of KSHV-seropositive HIV-infected patients; and 19% (3/16) of KSHV-seropositive healthy people. Organ transplant recipients had a significantly higher rate of KSHV DNAemia than healthy people ( P < 0.05). The 13 KSHV strains that were analyzed were genetically close to the Hungary AY707887 strain and belonged to the A3 subtype. Conclusions The seroprevalence of KSHV was elevated in renal transplant recipients and HIV-infected patients in China, and KSHV DNAemia was more common in these patients and liver transplant recipients. KSHV strains from Zhejiang Province belonged to the A3 subtype.