Viral co-infections and paraproteins in HIV: effect on development of hematological malignancies

Abstract

The role of viral co-infections and paraproteins in the development of hematological malignancies (HMs) in HIV remains unclear. Using our large database of HIV+ patients, we investigated whether co-infection and paraproteinemia increase the risk of HM. Data on demographics, hepatitis B (HBV) and hepatitis C virus (HCV) co-infections, paraproteinemia, HIV characteristics, and biopsy proven malignant hematological disorders for HIV+ patients were collected over a 10-year period in a large urban hospital setting. We identified 10,293 HIV+ patients who were followed for a median duration of 53 months. Of the 10,293 patients with HIV, 229 (2.2 %) were diagnosed with a HM. Over 85% of patients in both groups were tested; no significant difference in the prevalence of chronic HBV or HCV was noted between the HM positive (n = 229) and HM negative (n = 9992) patients. The serum protein electrophoresis test was performed for 1371 of the 10,221 patients. HM positive patients, compared to HM negative, were more likely to be tested for paraproteins (OR 3.3, 95 % CI 2.5–4.4) and more likely to have a discrete paraprotein band (OR 3.3, 95 % CI 1.2–8.9). Discrete paraproteins exclusively correlated with the development of plasma cell malignancies. Faint or oligoclonal protein bands were seen in high grade B cell lymphomas but did not show a significant correlation with HM development. Chronic hepatitis B or C infections did not correlate with the development of HM in HIV; however, viral influence on host gene transformation may have been impacted by anti-viral therapy limiting the duration of high viremic states.

Mid-arm muscle circumference as a substantial factor against mortality among people with elevated gamma gaps

“…Gamma gap is also known as paraprotein gap or globulin gap [ 7 ]. High gamma gap has important implications of inflammatory states [ 8 , 9 , 10 ]. Albumin, the most abundant protein in plasma, serves as a circulating depot for endogenous and exogenous compounds [ 11 ]; however, viral infection, malignancies and autoimmune diseases lead to excessive production of immunoglobulins, which raise the level of gamma gap independent of albumin [ 12 ].…”

Fulminant anaplastic large cell lymphoma (ALCL) concomitant with primary cytomegalovirus (CMV) infection, and human herpes virus 8 (HHV-8) infection together with Epstein-Barr-virus (EBV) reactivation in a patient with asymptomatic HIV-infection

“…HBV has only been associated with hepatocellular cancer as an effect of the chronic inflammation in the liver. There is no increased risk of haematological malignancies in HIV-patients with chronic hepatitis B compared to other HIV-infected patients as shown by Jou et al [25]. HHV-8 infects dendrite cells and B cells [26].…”

Pancytopenia as the main manifestation of human immunodeficiency virus infection in the AIDS stage

“…Monoklonální gamapatie nejasného významu je u osob infikovaných HIV relativně častým jevem, údaje o riziku progrese do plazmocelulární neoplazie se v jednotlivých studiích liší (8)(9)(10).…”