00:01
Getting now to the end, we have
HHV8, or human herpesvirus 8,
which has been named Kaposi's sarcoma-
associated herpesvirus.
00:11
Again, you'll mostly hear people
say Kaposi's virus.
00:14
This transmission is via mucosal
secretions, so saliva,
but especially sexual contact.
00:22
And the patients who develop diseases
with this particular virus
are those who are immunosuppressed,
either via HIV infection,
which is extended to AIDS, or those
who are transplant recipients, primarily
solid organ transplant patients,
because they have a specific very
immunosuppressive type
of medication which puts them at risk.
00:44
There are four epidemiologic forms of Kaposi
sarcoma, all caused by Kaposi's
sarcoma associated Herpesvirus, which is
also known as human herpesvirus eight.
00:54
Hhv eight. The first and perhaps most
familiar, is or are the AIDS
related or epidemic Kaposi's sarcoma.
01:02
This is the most common tumor arising in HIV
infected people, and it is
thankfully much less common in the United
States and other parts of the world where
antiretroviral therapy has been successfully
introduced.
01:15
Demonstration of the Kaposi sarcoma in these
patients is one of the AIDS
defining illnesses.
01:21
The second form is the endemic or African
form of Kaposi sarcoma.
01:26
This, of course, is mostly seen in
sub-Saharan Africa.
01:29
It did exist prior to the HIV epidemic, but
has been much more commonly
demonstrated since the spread of HIV.
01:36
Possibly due to the the immunosuppression of
that virus and emergence then
of the Kaposi's sarcoma associated
herpesvirus infection.
01:45
The third form are organ transplant
associated, so not HIV related,
but indeed due to chronic immunosuppression,
such as seen with
post transplant immunosuppression.
01:58
There may also be possible transmission of
the virus itself by that transplanted
organ. This is very similar to to what is
seen with cytomegalovirus
transmitted by an infected, transplanted
organ.
02:11
The clinical features of Kaposi sarcoma in
transplant associated disease are
very similar to those seen with classic
Kaposi sarcoma, meaning a slow
growing process.
02:22
And then finally, the classic Kaposi
sarcoma, which also is not HIV
related, is a slow growing cutaneous disease
most often seen in older men of
Mediterranean and Jewish origin.
02:34
Patients with a Kaposi's sarcoma
will demonstrate lesions such as you
see on the images in front of you.
02:41
. The sarcoma itself is very dark and
purplish, violet, to use the proper
term, and they're plaque-like
And you can actually see, especially in
the image on the right, sort of,
plaque-like skin on top of a purplish,
very circumscribed lesion
that actually -- both of those represent
vascular proliferation.
03:00
So, we're having a reactivation
to the virus itself,
causing -- as a proliferative faction
causing the sarcoma.
03:08
So, think of a sort of vascular or a
hemorrhagic appearing
plaque with scale on top of it, and that
will be your Kaposi's sarcoma.
03:18
So, that's a longer presentation because the
herpesviruses include some very
important pathogens,
many which we will see quite
commonly in medicine.
03:29
But if you can, sort of, keep
in mind the order, so
the herpesviruses 1 and 2
are herpes simplex virus.
03:36
3 is going to be varicella-zoster virus,
chicken pox.
03:40
4 is going to be Epstein-Barr virus,
5 will be cytomegalovirus.
03:46
6 and 7 are the roseola viruses,
and 8 is the Kaposi's sarcoma virus.
03:52
Put all those together and you got
a whole bunch of badness,
which unfortunately, we'll all probably
see quite frequently.