Oral Plasmablastic Lymphomas in AIDS Patients Are Associated With Human Herpesvirus 8

Abstract

Human herpes virus type 8 (HHV8) has been strongly associated with Kaposi sarcoma, primary effusion lymphoma (PEL), and Castleman's disease. To our knowledge, infection by this virus has not been strongly associated with other hematopathologic malignancies. We examined five oral cavity lymphomas from men with AIDS for HHV8 and HIV-1 by reverse transcriptase in situ polymerase chain reaction, as well as for Epstein-Barr virus (EBV) (EBER-1, -2) using in situ hybridization and HHV8 protein with immunohistochemistry. Four of these tumors were plasmablastic lymphomas; the final case was diffuse large B-cell lymphoma. Most of the neoplastic cells in these five lymphomas contained HHV8 RNA and protein. Further, the four plasmablastic lymphoma cases had tumor cells that contained EBV. HIV-1 RNA was not detected in the tumor cells but was noted in surrounding benign T cells. In comparison, HHV8 RNA was not detected in any of the five oral cavity lymphomas from people who did not have acquired immunosuppression nor in five lymphomas from AIDS patients that were located at a site other than the oral cavity. It is concluded that oral cavity lymphomas from people with AIDS are strongly associated with infection by HHV8 and EBV. Given the poor prognosis of oral cavity lymphomas in immunocompromised patients, therapy directed against the HHV8 and EBV infection may be of therapeutic value.

Large Cell Lymphoma: Correlation of HIV Status and Prognosis with Differentiation Profiles Assessed by Immunophenotyping

“…They concluded that the HHV-8 DNA detected by PCR was most likely due to the presence of infected bystander circulating (non neoplastic) lymphocytes. 140 The discrepant findings, relative to those of Coic et al 137 in which HHV-8 was demonstrated in most of the tumour cells, may be attributed to differences in methodology and the HHV-8 antibody used. Carbone et al 141 were subsequently prompted to re-evaluate the possible presence of HHV-8 infection in plasmablastic lymphomas of the oral cavity.…”

HIV‐associated plasmablastic lymphoma: Lessons learned from 112 published cases

“…Cases of plasmablastic microlymphoma, an emerging phenomenon described in HIV-infected patients often with preexistent multicentric Castleman disease, were excluded from this study. HHV8-positive PBL cases were also excluded from the analysis as great controversy in the present literature exists as to the role of this oncovirus in PBL pathogenesis [38,39,[48][49][50][51]. Unpublished data and cases reported in abstract form only were also excluded.…”

AIDS and associated malignancies

“…These tumors are generally associated with EBV and HHV-8 (10). Response to conventional chemotherapy is poor and some investigators have suggested that viral targeted approaches may be beneficial [12].…”