Suppression of HHV-8 viremia by foscarnet in an HIV-infected patient with Kaposi's sarcoma and HHV-8 associated hemophagocytic syndrome.
Human herpes virus 8 (HHV-8) seems to be involved in the pathogenesis of Kaposi s sarcoma. In vitro, antiviral drugs with activity against herpes viruses also can suppress HHV-8, however, little is known about the antiviral activity against HHV-8 in vivo. In this report we describe the effects of foscarnet on HHV-8 viremia in an HIV-infected patient with disseminated Kaposi s sarcoma and a presumably HHV-8 associated hemophagocytic syndrome. HHV-8 DNA could be detected in this patient by PCR in peripheral blood mononuclear cells (PBMC), in bronchoalveolar fluid and tumor biopsies. After initiation of foscarnet because of a severe hemophagocytic syndrome HHV-8 PCR turned negative in PBMC, but stayed positive in pleural effusions and in a tumor biopsy. After termination of foscarnet therapy HHV-8 DNA in PBMC persistently reappeared. Under treatment with foscarnet the hemophagocytic syndrome dramatically improved, suggesting that HHV-8 had a pathogenetic role in this syndrome.
Löw
P
P
Department of Medicine III with Institute of Clinical Immunology, University of Erlangen-Nuremberg, Krankenhausstrasse 12, D-91054 Erlangen, Germany.
Neipel
F
F
Rascu
A
A
Steininger
H
H
Manger
B
B
Fleckenstein
B
B
Kalden
J R
JR
Harrer
T
T
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D017245:Foscarnet / Q000627:therapeutic use*; D015497:HIV-1; D019288:Herpesvirus 8, Human / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity; D015616:Histiocytosis, Non-Langerhans-Cell / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D006801:Humans; D008297:Male; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000821:virology; D014766:Viremia / Q000188:drug therapy*
D000998:Antiviral Agents; D004279:DNA, Viral; D017245:Foscarnet