This piece won the OpiniUm Challenge, an academic research competition for the University of Miami’s graduate students to present their research in an op-ed.
Over 90% of the world’s population is infected with at least one herpesvirus. This family of viruses includes well-known players such as herpes simplex, which causes cold sores and even the virus responsible for chickenpox. However, there is a forgotten member of this group called Kaposi’s Sarcoma Herpesvirus (KSHV).
Its infamy surged years ago because unlike other herpesviruses, KSHV can induce cancer in humans. Despite its destructive abilities, KSHV has faded from public memory, but we urgently need to develop a vaccine to confront this pervasive infection.
A cancer virus emerges
Unexpectedly discovered during the height of the AIDS epidemic, KSHV was identified as the cause of Kaposi’s Sarcoma (KS), a cancer common to many living with HIV. This cancer became an AIDS-defining illness in the 1980s and gained public attention through films like “Philadelphia” (1993), where actor Tom Hanks portrayed a man suffering from KS.
With the explosive rise of HIV cases in the 1980s, KSHV spread rapidly through the population. KS appears as purple spots on the skin, and patients who developed these tumors were severely stigmatized. Fortunately, therapies used to combat HIV led to a dramatic decrease in new KS cases.
Kaposi’́s Sarcoma in our modern world
So why do we care about this disease today?
As a PhD student in microbiology and immunology, I am tackling this question by studying the intersection of cancer and viruses. Unraveling the answer has unearthed a grim reality.
First, after 30 years since its discovery, there is still no FDA-approved test for KSHV infection. Even more striking is that for over 20 years, treatment for KS has gone virtually unchanged.
This is concerning, especially because studies have shown that many patients do not respond well to existing therapies. In the United States, KS disproportionately affects marginalized communities. Men who are Black or Hispanic have much higher incidence of the cancer, and Black men specifically have higher mortalities than any other groups.
Globally, the disparity is even more alarming. While regions in Asia and Europe report low frequency of KSHV, research has revealed that up to 90% of the people in sub-Saharan Africa are living with this virus. For countries like Malawi and Uganda, KS is the most common cancer in men. More distressing is that unlike in the rest of the world, childhood KS is common and quickly fatal in sub-Saharan countries, adding to the dire situation there.
From bench to bedside
In 2023, the International Conference on KSHV was hosted in Tanzania, the first time ever on the African continent. This annual meeting brought together leading KSHV researchers with the aim of connecting these scientists with the people most burdened by KS. I had the opportunity to attend this week-long meeting to present my research on how KSHV hijacks the cellular machinery within our bodies.
While discussing these new findings with other scientists was undoubtedly important, the most impactful aspect of this conference was sitting with and listening to KS patients. This was the first time I had ever met a patient diagnosed with the cancer I am studying.
For many researchers, direct patient interactions are rare. This disconnect is one reason why it can take an astounding 15 years or more for discoveries in laboratories to translate into practical treatments.
One encounter at this conference left a lasting impression on me. At the Ocean Road Cancer Institute in Dar es Salaam, Tanzania, I met a KS patient, whom I will call Omar. He was unable to stand due to the progression of the tumor to his foot, so I stood bedside and listened to him share his medical journey following cancer diagnosis. As a rural farmer, Omar could not travel the vast distance to the Cancer Institute, which delayed his treatment. He recounted how this eventually led to his KS tumor advancing and leaving him immobile and bedridden. Hearing Omar’́s story was a sobering reminder of the urgent need for immediate action to prevent KSHV from causing this disease.
Eliminating KSHV
Although a cure for KS is necessary, there is one major barrier for stopping the formation of this cancer altogether: the absence of a vaccine against KSHV.
Scientists estimate that viruses are responsible for an astonishing 15-20% of cancers worldwide. Unbelievably, despite identifying seven cancer viruses in humans, there are only two vaccines that have been developed against these viruses. Designing a potent KSHV vaccine would not only be beneficial for stopping new KS cases but also serve as a blueprint to engineer vaccines targeting other cancer viruses.
Unfortunately, advancing these anti-cancer vaccines is not at the forefront of today’́s research enterprise. This must change. Choosing to guard the most vulnerable people, like Omar, from KSHV and other cancer viruses needs to become a public health priority.
Christian McDonald is a PhD candidate in Microbiology and Immunology at the University of
Miami-Miller School of Medicine, where his dissertation research focuses on the molecular mechanisms underlying KSHV oncogenesis.