Prognostic value of quantitative Kaposi sarcoma-associated herpesvirus load in posttransplantation Kaposi sarcoma

Organ transplant recipients have a higher risk of Kaposi sarcoma (KS). A quantitative real-time polymerase chain reaction assay was developed to evaluate KS-associated herpesvirus (KSHV) as a prognostic tool in transplant recipients with KS. Forty-three patients who developed KS after transplantation were included in a cross-sectional study to correlate virus load with transplantation or KS parameters. Seventeen patients (40%) had KSHV viremia (>100 copies/mug of DNA; median, 6067 copies/mug of DNA). Factors associated with these levels of viremia by univariate analysis were progression of KS (P = .00002), time from KS diagnosis (P = .0007), actual stage of KS (P = .006), initial stage of KS (P = .22), graft loss (P = .013), and time from transplantation (P = .0246). Disease progression remained associated with KSHV viremia in a multivariate analysis (P = .01). Thus, quantification of KSHV load in peripheral blood mononuclear cells could represent a useful tool for monitoring transplant recipients with KS.