Elevated virus loads of Kaposi's sarcoma-associated human herpesvirus 8 predict Kaposi's sarcoma disease progression, but elevated levels of human immunodeficiency virus type 1 do not.
Kaposi's sarcoma-associated herpesvirus (KSHV) is found in Kaposi's sarcoma (KS), multicentric Castleman's disease, and primary effusion lymphomas. To prospectively evaluate KSHV load as a biomarker for KS clinical status and prognosis in a cohort of men with AIDS-related KS, 2 quantitative polymerase chain reaction (PCR) assays were developed and tested to determine KSHV peripheral blood mononuclear cell (PBMC) virus loads. Most patients (13/15) with good-prognosis KS had < or =1.5 log KSHV copies/10(5) PBMC by both quantitative competitive (QC) and real-time Applied Biosystems (ABI) PCR. Both assays provided 94% specificity for identifying the 16 patients without KS progression during 20 months of follow-up. QC-PCR and ABI-PCR exhibited 100% and 80% levels of diagnostic sensitivity, respectively, for identifying the 5 patients whose KS progressed. Neither dichotomized human immunodeficiency virus loads nor dichotomized CD4 counts predicted either KS progression or KS clinical stage (all positive predictive values < 30%). These results are evidence that the quantity of circulating KSHV in KS patients is biologically meaningful and is measurable with sufficient accuracy to provide clinically useful information.
Quinlivan
E Byrd
EB
Department of Medicine, Lineberger Comprehensive Cancer Center, 547 Burnett-Womack Building, University of North Carolina, Chapel Hill, NC 27599, USA. ebq@med.unc.edu
Zhang
Chuan
C
Stewart
Paul W
PW
Komoltri
Chulaluk
C
Davis
Michelle G
MG
Wehbie
Robert S
RS
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D002478:Cells, Cultured; D018450:Disease Progression; D015497:HIV-1; D019288:Herpesvirus 8, Human; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012514:Sarcoma, Kaposi / Q000821:virology*; D019562:Viral Load