Immune profiling in solid organ transplant recipients with HHV-8 infection: Identification of immunological biomarkers for KICS and Kaposi's sarcoma

Human Herpesvirus 8 (HHV-8) poses a significant risk in solid organ transplant recipients (SOTRs). HHV-8 is implicated in both neoplastic and non-neoplastic conditions. This study investigates immune dysregulation in HHV-8-infected SOTRs by analysing cytokine profiles and virus-specific T cell responses across different clinical manifestations. Our findings reveal a progressive decline in HHV-8-specific T cell responses correlating with disease severity, alongside a distinct cytokine signature. KICS patients exhibit heightened inflammation with elevated IL-6, IL-10, IFNα, TNFα, IL-1β, IL-17 A, IDO, sCD14, and immune exhaustion markers (PD-1, LAG-3), whereas KS is associated with angiogenic and macrophage activation factors (HGF, CD163). Given these insights, monitoring HHV-8 DNAemia, inflammatory cytokines, and T cell functionality is crucial for early detection and risk stratification. This study underscores the importance of immune monitoring in transplant recipients, paving the way for targeted interventions to mitigate HHV-8-associated complications.