title: Localisation of HHV-8 in AIDS related lymphadenopathy.
abstract: BACKGROUND
  Many lymph node abnormalities have been described in AIDS. These include opportunistic infections that sometimes result in spindle cell pseudotumours, Kaposi's sarcoma (KS), malignant lymphoma (Hodgkin's and non-Hodgkin's), and florid reactive hyperplasia. Among these, reactive hyperplasia is the most common manifestation of AIDS related lymphadenopathy.
  
  
  OBJECTIVE
  To examine whether human herpesvirus 8 (HHV-8), the aetiological agent of KS, can be localised in AIDS related lymphadenopathy and whether its appearance in such nodes is predictive of Kaposi's sarcoma development.
  
  
  METHODS
  A series of human immunodeficiency virus (HIV) positive men (n = 21) with AIDS related lymphadenopathy who at the time of presentation had KS or subsequently developed KS (n = 5) were examined. The prevalence of HHV-8 was assessed in these patients using solution phase polymerase chain reaction (PCR), real time TaqMan quantitative PCR, and in cell amplification techniques (PCR in situ hybridisation (PCR-ISH) and labelled primer driven in cell amplification).
  
  
  RESULTS
  Using standard solution phase PCR in a nested format, only two of the 21 patients with AIDS related lymphadenopathy were positive for HHV-8. The lymph node of one of these patients contained KS lesions. Three HHV-8 positive patients were identified using TaqMan PCR (the original two positive patients and one additional patient). All of the positive patients either subsequently developed KS (n = 2) or had KS at the time of diagnosis (n = 1). Two additional patients subsequently developed KS, but were negative for HHV-8 by solution phase PCR and TaqMan PCR. Using PCR-ISH, HHV-8 amplicons were identified in some lymphoid cells (in one patient) and in spindle cells of the KS lesion in another. The positive lymphoid cells were predominantly concentrated in B cell areas of the affected lymph nodes, confirming the B cell tropism exhibited by HHV-8.
  
  
  CONCLUSIONS
  The presence of HHV-8 in AIDS related lymphadenopathy is predictive of KS development and probably represents seeding of HHV-8 infected B cells from the peripheral blood. These findings support a role for HHV-8 in the pathobiology of KS.
authors.affiliation: Department of Pathology, Coombe Women's Hospital, Dublin, Ireland. joleary@gw.coombe.ie
authors.forename: J J
authors.initials: JJ
authors.lastname: O'Leary
authors.forename: M
authors.initials: M
authors.lastname: Kennedy
authors.forename: K
authors.initials: K
authors.lastname: Luttich
authors.forename: V
authors.initials: V
authors.lastname: Uhlmann
authors.forename: I
authors.initials: I
authors.lastname: Silva
authors.forename: J
authors.initials: J
authors.lastname: Russell
authors.forename: O
authors.initials: O
authors.lastname: Sheils
authors.forename: M
authors.initials: M
authors.lastname: Ring
authors.forename: M
authors.initials: M
authors.lastname: Sweeney
authors.forename: C
authors.initials: C
authors.lastname: Kenny
authors.forename: N
authors.initials: N
authors.lastname: Bermingham
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: O'Donovan
authors.forename: D
authors.initials: D
authors.lastname: Howells
authors.forename: S
authors.initials: S
authors.lastname: Picton
authors.forename: S B
authors.initials: SB
authors.lastname: Lucas
mesh_terms: D000386:AIDS-Related Complex / Q000150:complications / Q000821:virology*; D019288:Herpesvirus 8, Human / Q000235:genetics*; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012514:Sarcoma, Kaposi / Q000209:etiology / Q000821:virology*