Pulmonary manifestations of human herpesvirus-8 during HIV infection

Abstract

Human herpesvirus (HHV)-8 is an oncogenic gamma herpesvirus that was first described in 1994 in Kaposi sarcoma lesions. HHV-8 is involved in the pathophysiological features of multicentric Castleman's disease (MCD) and primary effusion lymphoma (PEL), both rare B-cell lymphoproliferative diseases. HHV-8-related tumours occur almost exclusively in immunocompromised patients, mostly those with HIV infection. Combined antiretroviral therapies have reduced the incidence of Kaposi sarcoma but not MCD and PEL.HHV-8-related diseases frequently exhibit pulmonary involvement, which may indicate the disease. Kaposi sarcoma in the lung is often asymptomatic but may require specific therapy. It mostly shows cutaneous or mucosal involvement. Patients with typical MCD present fever and lymphadenopathy associated with interstitial lung disease without opportunistic infection. Specific treatment may be urgent. PEL provokes a febrile, lymphocytic-exudative pleural effusion, without a pleural mass on computed tomography scan. Rapid diagnosis prevents unnecessary examinations and leads to specific, rapid treatment. Therapy is complex, combining antiretroviral therapy and chemotherapy. @ERSpublications HHV-8-related diseases frequently exhibit pulmonary involvement, which may indicate the disease

Upper gastrointestinal Kaposi's sarcoma in HIV-infected patients: ten years of endoscopy observation at a single Brazilian center

“…17,18 Pulmonary lesions are generally asymptomatic and associated with concurrent cutaneous manifestations of KS. 19 The role of HAART in the reduction of the incidence of opportunistic infections and malignant neoplasms among HIVpositive individuals is well established. 1,20 In the present study, 55% of the patients were on HAART for a mean 3 months before upper GI endoscopy.…”

Kaposi Sarcoma in HIV Infected Patients

“…The retrospective nature and the small number of patients are intrinsic limitations; since gastrointestinal and/ or pulmonary involvements are usually asymptomatic in HIV-related KS [20,21], the rate of organ involvement may have been clinically underdiagnosed. However, our results describe an aspect of the clinical picture for latepresenter HIV-positive patients diagnosed with KS, with severe evolution and rapid progression of disease.…”

Lymphoid Interstitial Pneumonia and Other Benign Lymphoid Disorders

“…62 HHV-8 infection is strongly associated with MCD and is responsible for most HIV-positive MCD and half of HIV-negative MCD. [63][64][65] Patients affected by MCD are at an increased risk of lymphoma and other related neoplasms, including Kaposi sarcoma and follicular dendritic cell tumors. 60,62,63 These associations suggest a major role for immune system dysregulation in the pathogenesis of CD.…”