HHV-8 genotypes and clinical features in Kaposi sarcoma and primary effusion lymphoma in people living with HIV in Salvador, Brazil.

Authors

Carlos Frederico Lopes Benevides, Andreas Stocker, Sueli Moreno Vieira, Estela Luz, Carlos Brites

Published in

Frontiers in microbiology. Volume 17. Pages 1883222. Epub Jun 19, 2026.

Abstract

Human herpesvirus 8 (HHV-8) is the etiologic agent of Kaposi sarcoma (KS) and primary effusion lymphoma (PEL), important causes of morbidity and mortality among people living with HIV (PLWH). The highly polymorphic ORF-K1 region is commonly used for HHV-8 genotyping and phylogenetic analysis. We investigated the distribution of HHV-8 genotypes and their clinical correlates among PLWH diagnosed with KS or PEL in Salvador, Brazil.
Between 2022 and 2025, biological specimens from PLWH with KS or PEL were prospectively collected, including skin biopsies, blood, pleural effusions, and serum samples. HHV-8 DNA was detected by real-time PCR, and positive samples underwent semi-nested PCR amplification and sequencing of the ORF-K1 region. Phylogenetic analyses were performed using Maximum Likelihood reconstruction with 602 reference HHV-8 K1 sequences obtained from GenBank. Clinical, virological, and immunological data were analyzed according to HHV-8 genotype.
HHV-8 DNA was successfully sequenced in 14 of 19 samples. Phylogenetic analysis identified subtype C in 7/14 (50.0%) cases, subtype B in 4/14 (28.6%), and subtype A in 3/14 (21.4%). Most participants were men who have sex with men (86.6%), with a median age of 34 years. Among 13 patients with available clinical data, eight (61.5%) presented with high-risk KS or PEL. Genotype A was detected in patients with aggressive disease manifestations, including visceral KS and PEL, whereas subtype C was predominantly associated with mucocutaneous disease. However, no statistically significant association was observed between genotype and disease severity (Fisher-Freeman-Halton exact test, p = 0.4639). Phylogenetic reconstruction also identified a distinct cluster containing two previously reported A5 isolates that segregated from recognized HHV-8 subtypes.
HHV-8 subtype C was the predominant genotype among PLWH with KS or PEL in Salvador, followed by subtypes B and A. Although limited by sample size, subtype A was observed only in patients with severe diseases, consistent with previous reports suggesting an association between subtype A and severe clinical presentations. The identification of a distinct phylogenetic branch expands current knowledge of HHV-8 genetic diversity and warrants further investigation. These findings improve understanding of HHV-8 molecular epidemiology and provide insights for future studies evaluating genotype-phenotype associations.

PMID:
42404792
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

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