Obstructive cholangiopathy patient caused by cytomegalovirus and Kaposi sarcoma in a person living with HIV and hepatitis C

Islas-Muñoz, Beda; Méndez-Sotelo, B; Reyes-Pérez, Juan Armando; Santos, Marco; Herrera‐Goepfert, Roberto; Volkow-Fernández, Patricia

doi:10.1177/0956462420943027

Cited by 1 publication

(1 citation statement)

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“…New pharmacologic treatments derived from clinical trials have been studied for KSHV infection, including monoclonal antibodies such as pembrolizumab (anti-PD1), chemotherapy with pomalidomide (anti-angiogenic agent) or paclitaxel (antimicrotubular agent), and kinase inhibitors such as selumetinib [ 7 , 15 ]. Valganciclovir (VGC), an oral prodrug of ganciclovir that inhibits viral DNA synthesis, is a standard gold treatment for treating cytomegalovirus end-organ disease and secondary prophylaxis; it has been demonstrated to have an antiviral effect against HHV-8 in vitro, and several studies have proposed the clinical use of VGC as an antiviral to reduce HHV-8 replication in KS/HIV patients [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Valganciclovir as Add-On Therapy Modifies the Frequency of NK and NKT Cell Subpopulations in Disseminated Kaposi Sarcoma Patients

Flores‐González

Ramón‐Luing

Ocaña-Guzmán

et al. 2022

Cancers

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Human herpesvirus-8 infection (HHV-8) is the causative agent of Kaposi sarcoma (KS) and is highly prevalent among people living with HIV (KS/HIV). It has been reported that valganciclovir (VGC) reduces HHV-8 replication in KS/HIV patients. However, currently it is unclear if VGC modifies the frequency and induces changes in markers of immune regulation of immune cells necessary to eliminate HHV8-infected cells, such as Natural Killer (NK) and NK T cells (NKT). This study evaluated the effect of VGC used as antiviral HHV8 therapy in KS patients on the frequency of NK and NKT subpopulations based on the CD27 and CD57 expression, and the immunosenescence markers, PD-1 and KLRG1. Twenty KS/HIV patients were followed-up at baseline (W0), 4 (W4), and 12 weeks (W12) of the study protocol. Among them, 10 patients received a conventional treatment scheme (CT), solely antiretroviral therapy (ART), and 10 patients received a modified treatment regime (MT), including VGC plus ART. In both groups, bleomycin/vincristine was administrated according to the treating physician’s decision. The soluble levels of IL-15, PD-L1, PD-L2, and E-cadherin were quantified across the follow-up. Our results showed that the higher IL-15 levels and lower NK frequencies cells in KS/HIV patients reach almost normal values with both treatments regimes at W12. CD27+ NK and NKT cell frequencies increased since W4 on KS/HIV patients with MT. Furthermore, PD-1 expression decreased while KLRG1 increased on NK and NKT subpopulations at W12, and it is accompanied by increased PD-L1 plasma level since W4. Our study highlights the disruption of NK and NKT subpopulations in patients with KS/HIV and explores VGC treatment’s contribution to immune reconstitution during the first weeks of treatment.

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