Clearance of human herpesvirus type 8 viraemia in HIV-1-positive patients with Kaposi's sarcoma treated with liposomal doxorubicin. Caelyx/KS Spanish Study Group.
OBJECTIVE
To assess the impact of liposomal doxorubicin on human herpesvirus type 8 (HHV-8) cell viraemia in HIV-infected patients with Kaposi's sarcoma.


METHODS
Prospective, non-controlled, multicenter study.


METHODS
The presence of HHV-8 DNA was investigated by polymerase chain reaction in peripheral blood mononuclear cells from 46 HIV-positive patients with Kaposi's sarcoma. Samples were tested at baseline and every 3 months during treatment with liposomal doxorubicin. CD4 cell counts, plasma HIV RNA, and clinical outcome were recorded at baseline and at follow-up visits.


RESULTS
HHV-8 sequences were detected in 32 (70%) patients at baseline. No significant differences were found between subjects with HHV-8 positive and negative results. The proportion of patients with positive HHV-8 viraemia decreased to 38% (10 of 26) after 3 months of treatment with liposomal doxorubicin (P < 0.01). Overall, 12 of 22 (57%) subjects with positive HHV-8 cell viraemia at baseline became negative during the treatment period. However, in one of them HHV-8 reappeared 8 months later despite being on therapy. On the other hand, six of eight subjects with negative HHV-8 at baseline remained negative thereafter. There were no significant changes in plasma HIV RNA, total lymphocyte, or CD4 cell counts during the treatment period. Clinical response of Kaposi's sarcoma to liposomal doxorubicin and clearance of HHV-8 viraemia did not correlate well.


CONCLUSIONS
HHV-8 cell viraemia significantly decreased during treatment with liposomal doxorubicin in HIV-infected patients with Kaposi's sarcoma, although the clinical response and HHV-8 clearance did not correlate well.
Núñez
M
M
Service of Infectious Diseases, Hospital Carlos III, Instituto de Salud Carlos III, Madrid, Spain.
Machuca
A
A
Soriano
V
V
Podzamczer
D
D
González-Lahoz
J
J
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000821:virology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D019288:Herpesvirus 8, Human / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D008081:Liposomes; D008297:Male; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000821:virology; D016896:Treatment Outcome; D014766:Viremia / Q000188:drug therapy / Q000821:virology
D000970:Antineoplastic Agents; D004279:DNA, Viral; D008081:Liposomes; D012367:RNA, Viral; D004317:Doxorubicin