Plasma HHV-8 viral load in HHV-8-related lymphoproliferative disorders associated with HIV infection

J Med Virol. 2009 May;81(5):888-96. doi: 10.1002/jmv.21349.

Abstract

This is a mono-institutional analysis of the clinical features, immunological and virological findings, and prognostic factors of patients with HIV infection and HHV-8-lymphoproliferative disorders. Patients with Multicentric Castleman Disease and HHV-8-related lymphoma diagnosed and treated from April 1987 to June 2004 were included in the study. HHV-8 and HIV plasma viral load, CD4+ count, hematologic parameters, and general wellbeing (performance status) were assessed at the onset of the diseases and analyzed in order to identify possible prognostic factors. Nine patients with Multicentric Castleman disease, and 16 with HHV-8-related lymphomas (13 primary effusion lymphomas and 3 solid lymphomas), were diagnosed and treated out of 327 HIV-related non-Hodgkin's lymphomas. Four patients with Multicentric Castleman disease received only antiretroviral drugs; 5 HAART plus oral etoposide. Nine patients with primary effusion lymphoma were treated with a CHOP-like regimen (Cyclophosphamide, Prednisone anthracyclines, Vinca alkaloids, Bleomycin, Etoposide) and HAART; 1 with etoposide and HAART, 1 with HAART alone. The patients with solid lymphoma underwent CHOP-like chemotherapy. Patients with Multicentric Castleman disease showed lower median values of HHV-8 viral load and longer overall survival compared with HHV-8-related lymphomas. Patients with viral load of HHV-8, >40,000 cp/ml had a significant shorter overall survival. In the univariate analysis, HHV-8-related lymphoma, HHV-8 viral load >40,000 cp/ml and performance status >2 were associated with an increased risk of death. Multivariate analysis confirmed the diagnosis of lymphoma as an independent predictor of shorter survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Castleman Disease / complications
  • Castleman Disease / diagnosis
  • Castleman Disease / drug therapy
  • Castleman Disease / virology
  • DNA, Viral / blood
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / virology
  • Herpesviridae Infections / complications*
  • Herpesviridae Infections / drug therapy
  • Herpesviridae Infections / virology
  • Herpesvirus 8, Human / genetics
  • Herpesvirus 8, Human / isolation & purification
  • Herpesvirus 8, Human / physiology*
  • Humans
  • Lymphoma / complications
  • Lymphoma / diagnosis
  • Lymphoma / drug therapy
  • Lymphoma / virology
  • Lymphoma, AIDS-Related / diagnosis
  • Lymphoma, AIDS-Related / drug therapy*
  • Lymphoma, AIDS-Related / virology
  • Lymphoma, Primary Effusion / complications
  • Lymphoma, Primary Effusion / diagnosis
  • Lymphoma, Primary Effusion / drug therapy
  • Lymphoma, Primary Effusion / virology
  • Lymphoproliferative Disorders / complications*
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / drug therapy
  • Lymphoproliferative Disorders / virology
  • Male
  • Middle Aged
  • Prognosis
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome
  • Viral Load*
  • Young Adult

Substances

  • Antineoplastic Agents
  • DNA, Viral