The incidence of human herpes virus-8 expression in lymph node biopsies from human immunodeficiency virus-positive patients.
OBJECTIVE
Human immunodeficiency virus (HIV)-related lymphadenopathy is characterized by a wide spectrum of histological changes. Three patterns have been described which correspond to clinical stages of HIV/acquired immune deficiency syndrome (AIDS). Castleman disease is a heterogeneous group of disorders. A recently described variant, multicentric Castleman disease (MCD), of which some cases are associated with human herpes virus-8 (HHV-8), has been reported in both HIV-seropositive and -negative patients. Considerable morphological overlap occurs between one of the patterns of HIV lymphadenopathy and this variant.


RESULTS
This retrospective histopathological study on 95 cases of HIV-reactive lymphadenopathy assessed the incidence of the different patterns and HHV-8 on immunohistochemistry (IHC). Of the 95 cases, 78 (82.1%) were HHV-8-negative, of which 46 (59.0%) were classified as pattern A, 20 (25.6%) as pattern B and 12 (15.4%) as pattern C. Nine (31.0%) of 29 cases with pattern B and 8 (40.0%) of 20 cases with pattern C were HHV-8 positive. In total 15 cases of MCD were diagnosed in this series.


CONCLUSIONS
This study draws attention to the overlap between HIV lymphadenopathy and MCD. We recommend that cases of HHV-8-associated MCD should be investigated for HIV infection.
Department of Anatomical Pathology, Faculty of Health Sciences, University of the Free State and National Health Laboratory Service, Bloemfontein, South Africa. beukesca@ufs.ac.za
Catherine A
CA
Beukes
Jacoretha
J
Thiart
D000386:AIDS-Related Complex / Q000150:complications / Q000473:pathology / Q000821:virology; D000293:Adolescent; D000328:Adult; D000368:Aged; D005871:Castleman Disease / Q000150:complications / Q000473:pathology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D015658:HIV Infections / Q000150:complications / Q000473:pathology / Q000821:virology*; D006566:Herpesviridae Infections / Q000150:complications / Q000473:pathology / Q000821:virology; D019288:Herpesvirus 8, Human / Q000302:isolation & purification* / Q000472:pathogenicity; D006801:Humans; D007223:Infant; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult