The long term risk of malignancies in renal transplant patients is approximately 100 times that in general population. Unlike North America and many European countries, Kaposi's sarcoma is the most common cancer after renal transplantation in most series reported from countries like Iran and Saudi Arabia.
Human herpes virus 8 (HHV-8) has a major role in pathogenesis of Kaposi's sarcoma. Risk of post transplant Kaposi's sarcoma is 23-28% in seropositive compared to 0.7% in those who are seronegative. This study was conducted to investigate the seroprevalence of HHV-8 in our transplant recipients
Serum of 100 renal transplant recipients were checked by indirect immunofluorescence against latent nuclear antigen.Results were analyzed by SPSS10. T test, chi-square and Fisher's exact test were used. Out of 100 patients 60 were male. Mean age was 41.1 (range 17-74 year) and 17 patients were older than 55. Mean of duration on transplantation was 41.6 months (range 1-166 months).
Induction with ALG was done in 24% of patients. 97 patients had received prednisolone (69% of patients ≤10 mg/day). Mycofenolate Mofetil was used by 72% of patients, and Azathioprin by 23% (7/23 less than 75 mg/day). 98% of patients had received Cyclosporin (Neoral), with a dose of less than 3.5mg/kg in 54% of patients Twenty five percent of patients were seropositive for HHV-8. There was statistically significant seropositivity for HHV-8 in recipients older than 55 years old. (P value= 0.02). 8/17 patients older than 55 year were seropositive (47%) whereas 20 % of patients younger than 55 year were seopositive( 17/83). Mean of duration on transplantation in recipients older than 55 years were 50.8 months versus 40.7 months in those younger than 55 and this difference was not statistically significant.
There were not statistically significant differences for HHV-8 seropositivity regarding sex, duration on transplantation, immunosuppressive regimen or dose of immunosuppressive drugs and Cyclosporin blood level. We have shown seropositivity for HHV-8 in significant percentage of our renal transplant recipients that may render them at risk for developing Kaposi's sarcoma.