[HHV-8 Related immunological and hematological diseases]

Rev Med Interne. 2022 May;43(5):301-311. doi: 10.1016/j.revmed.2021.10.004. Epub 2021 Dec 9.
[Article in French]

Abstract

HHV-8 is an oncogenic Gammaherpesvirinae discovered in 1994 during the HIV pandemic. It is the causative agent of Kaposi's sarcoma, and is also associated with the occurrence of several aggressive B lymphoproliferative disorders. Most of them occur in an immunosuppression setting, usually due to HIV infection. Multicentric HHV8-associated Castleman's disease and KSHV Inflammatory Cytokine Syndrome (KICS) are primarily reactive entities with prominent systemic features. They illustrate the cytokinic storm induced by HHV-8 in its cell host. On the other hand, HHV-8 can drive proliferation and lymphomagenesis of its plasmablastic cell host, and is associated with a risk to develop aggressive lymphomas with plasmacytic differenciation. Primary effusion lymphoma usually localizes in body cavities and may affect other extra-nodal sites ; its prognostic is poor. Diffuse large B-cell lymphoma HHV-8, NOS affect more commonly nodes and blood and evolve from infected cell of HHV-8 associated Castleman disease. On the contrary, germinotropic lymphoproliferative disorders presents mainly as localized adenopathy with indolent course, and show polyclonality. Histology plays a key role in distinguishing these different entities and need expert reviewing, especially since they may be associated with each other. Besides lymphoproliferative disorders, HHV8 is associated with various hematological manifestations. The aim of this review is to provide an update on the presentation, diagnosis, and management of immunologic and hematologic complications associated with HHV-8.

Keywords: Castleman disease; Herpèsvirus humain type-8; Human herpes-virus type 8; Kaposi's sarcoma-associated herpesvirus; Lymphoma of the immunocopromised; Maladie de Castleman; Primary effusion lymphoma; Virus associé au sarcome de Kaposi; lymphomes associés aux séreuses; lymphomes de l’immunodéprimé.

Publication types

  • Review

MeSH terms

  • Castleman Disease* / diagnosis
  • Castleman Disease* / epidemiology
  • Castleman Disease* / therapy
  • HIV Infections*
  • Hematologic Diseases* / diagnosis
  • Hematologic Diseases* / epidemiology
  • Hematologic Diseases* / etiology
  • Herpesvirus 8, Human*
  • Humans
  • Lymphoproliferative Disorders* / diagnosis
  • Lymphoproliferative Disorders* / pathology
  • Sarcoma, Kaposi* / pathology

Supplementary concepts

  • Multi-centric Castleman's Disease