title: The clinical application of plasma Kaposi sarcoma herpesvirus viral load as a tumour biomarker: results from 704 patients.
abstract: OBJECTIVE
  The aim of the study was to evaluate the role of plasma Kaposi sarcoma herpesvirus (KSHV) as a diagnostic and prognostic biomarker in people living with HIV (PLWH) and diagnosed with KSHV-associated diseases.
  
  
  METHODS
  Using quantitative nested polymerase chain reaction (PCR) targeting the open reading frame-26 gene of KSHV, plasma levels of KSHV were measured in consecutive PLWH with KSHV-associated diseases or as part of the investigation of lymphadenopathy.
  
  
  RESULTS
  Plasma KSHV assays were performed on samples from 684 PLWH and 20 HIV-seronegative people with KSHV-associated malignancies. In PLWH, plasma KSHV was detected in 39% of those with KS, 99% of those with multicentric Castleman disease (MCD), 9% of those with non-Hodgkin lymphoma (NHL), 2% of those with non-AIDS-defining malignancies and 0% of those with nonmalignant lymphadenopathy. There was no significant difference in plasma KSHV viral load among those with KS, MCD and KSHV-associated NHL. The 5-year overall survival rate from KS diagnosis of 335 PLWH was 95.2% (95% confidence interval 92.6-97.8%). Plasma KSHV viraemia did not predict overall survival in those with KS (P = 0.73), nor when those with T0 stage KS (P = 0.52) or T1 stage KS (P = 0.62) were analysed separately.
  
  
  CONCLUSIONS
  Measuring the plasma levels of KSHV as a biomarker in KSHV-associated disease has a very limited value in either diagnosis or prognostication. The only potential role of clinical value is the suggestion that an undetectable plasma KSHV excludes a diagnosis of MCD in PLWH.
authors.affiliation: Imperial College School of Medicine, London, UK.
authors.forename: I-U
authors.initials: IU
authors.lastname: Haq
authors.affiliation: Department of Oncology, National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Dalla Pria
authors.affiliation: Department of Oncology, National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Papanastasopoulos
authors.affiliation: Department of HIV Medicine, National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Stegmann
authors.affiliation: Department of HIV Medicine, National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Bradshaw
authors.affiliation: Imperial College School of Medicine, London, UK.|Department of HIV Medicine, National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Nelson
authors.affiliation: Imperial College School of Medicine, London, UK.|Department of Oncology, National Centre for HIV Malignancies, Chelsea & Westminster Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Bower
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D018791:CD4 Lymphocyte Count; D005871:Castleman Disease / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000235:genetics*; D006801:Humans; D008297:Male; D011379:Prognosis; D012514:Sarcoma, Kaposi / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D016019:Survival Analysis; D019562:Viral Load
chemical_list: D014408:Biomarkers, Tumor; D004279:DNA, Viral
keywords: AIDS; HIV; KSHV; Kaposi sarcoma; multicentric Castleman disease; non-AIDS-defining malignancy; non-Hodgkin lymphoma