September 30, 2013
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Newer therapies prevent options for HHV-8 management

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Human herpesvirus-8 may be overlooked in children because its presentation often differs from that in adults, according to a review published online ahead of print.

Dorothy Dow, MD, a fellow in the division of pediatric infectious diseases at Duke Children’s Hospital and Health Center in Durham, N.C., and colleagues said, in recent years, there has been a rise in pediatric transplant patients with human herpesvirus-8 (HHV-8), also known as Kaposi’s sarcoma–associated herpesvirus, in addition to a rise in areas such as sub-Saharan Africa, where AIDS-associated pediatric Kaposi’s sarcoma is common. HIV complicates diagnosis and treatment decisions.

Dorothy Dow, MD, MScGH 

Dorothy Dow

Dow said although the optimal treatment options for this illness are still unclear, “the most common approach to treatment of solid organ transplant-associated [Kaposi’s sarcoma] involves reduction of immunosuppression and substitution of commonly used immunosuppressive agents such as tacrolimus for sirolimus ([mTOR] inhibitor) due to its antitumorigenic properties.”

Other therapies that are under investigation, according to Dow and colleagues, include paclitaxel, prostaglandin E2, antioxidants and anti-inflammatory drugs.

A major knowledge gap exists because of a lack of prospective data and targeted research, which is necessary to better understand viral transmission, progression to Kaposi’s sarcoma, and approaches to therapy in children, according to the researchers.

“This review is intended to update physicians on the current knowledge of HHV-8 in children and to serve as a reminder that HHV-8 can cause significant morbidity and mortality, especially in immunocompromised children,” Dow told Infectious Disease News.

Dorothy Dow, MD, MScGH, can be reached at Pediatric Infectious Diseases, DUMC 3499, Durham, NC 27710; email: dorothy.dow@duke.edu.

Disclosure: The researchers report no relevant financial disclosures.