Medicine & Health
Hematologic Malignancies in Malawi By Sneha Makhijani
Illustration by Hannah Kennedy
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ew people would have thought that it is possible to develop cancer by simply sharing their spoon of ice cream with a friend. However, the common human herpesvirus Kaposi’s sarcomaassociated herpes virus (KSHV) is transmitted through saliva (for instance on a spoon), sexual contact, or transfusion of contaminated blood or tissue. The virus hides in the body and does not usually cause problems unless the immune system is weakened in cases such as in those with human immunodeficiency virus (HIV). KSHV can cause multicentric Castleman disease (MCD) in some patients with HIV. MCD is a rare disease that presents with similar symp-
toms to lymphoma. The HIV/AIDS (acquired immune deficiency syndrome) epidemic greatly affected the African country of Malawi. The prevalence of HIV among adults is around 9% and before the link between HIV and cancer was well understood, many people living with HIV mysteriously suffered from lymphoma and other cancers. In 1990, the UNC Chapel Hill Institute for Global Health and Infectious Diseases, in collaboration with the Malawi Ministry of Health (MOH), formed Matthew Painschab, MD UNC Project Malawi in order to focus research and training around HIV and other sexually transmitted diseases (STDs). Since 1990, UNC Project Malawi has spearheaded treatment and research on HIV and STDs in Malawi with physicians like Dr. Matthew Painschab at the forefront. Dr. Painschab’s main research Figure 1. A representative lymph node biopsy from a patient with multicen- focus has been on HIV and its association with hematologic maligtric Castleman disease in Malawi demonstrating a) the classic convulted nancies, specifically the two blood cancers leukemia and lymphoma. germinal center surrounded by b) Kaposi sarcoma herpesvirus (KSHV)Dr. Painschab has always had a passion for public health and infected plasmablasts that stain brown for a protein made by KSHV. medicine as a first-generation college student with interests in biol-
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