Human herpesvirus 8 load and progression of AIDS-related Kaposi sarcoma lesions.
BACKGROUND
Human herpesvirus 8 (HHV8) is necessary for Kaposi sarcoma (KS) to develop, but whether peripheral blood viral load is a marker of KS burden (total number of KS lesions), KS progression (the rate of eruption of new KS lesions), or both is unclear. We investigated these relationships in persons with AIDS.


METHODS
Newly diagnosed patients with AIDS-related KS attending Mulago Hospital, in Kampala, Uganda, were assessed for KS burden and progression by questionnaire and medical examination. Venous blood samples were taken for HHV8 load measurements by PCR. Associations were examined with odds ratio (OR) and 95% confidence intervals (CI) from logistic regression models and with t-tests.


RESULTS
Among 74 patients (59% men), median age was 34.5 years (interquartile range [IQR], 28.5-41). HHV8 DNA was detected in 93% and quantified in 77% patients. Median virus load was 3.8 logs10/10(6) peripheral blood cells (IQR 3.4-5.0) and was higher in men than women (4.4 vs. 3.8 logs; p=0.04), in patients with faster (>20 lesions per year) than slower rate of KS lesion eruption (4.5 vs. 3.6 logs; p<0.001), and higher, but not significantly, among patients with more (>median 20 KS lesions) than fewer KS lesions (4.4 vs. 4.0 logs; p=0.16). HHV8 load was unrelated to CD4 lymphocyte count (p=0.23).


CONCLUSIONS
We show significant association of HHV8 load in peripheral blood with rate of eruption of KS lesions, but not with total lesion count. Our results suggest that viral load increases concurrently with development of new KS lesions.
Nsubuga
Martin M
MM
Makerere University Medical School, Kampala, Uganda.
Biggar
Robert J
RJ
Combs
Susan
S
Marshall
Vickie
V
Mbisa
Georgina
G
Kambugu
Fred
F
Mehta
Meghna
M
Biryahwaho
Benon
B
Rabkin
Charles S
CS
Whitby
Denise
D
Mbulaiteye
Sam M
SM
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000821:virology*; D019562:Viral Load