title: HHV-8 DNA replication correlates with the clinical status in AIDS-related Kaposi's sarcoma.
abstract: BACKGROUND
  The value of plasma levels of human herpesvirus 8 (HHV-8) DNA as a marker of clinical status in acquired immunodeficiency syndrome-related Kaposi's sarcoma (AIDS-KS) remains to be elucidated.
  
  
  OBJECTIVE
  To investigate the relationship between the plasma HHV-8 DNA viral load and the clinical status of AIDS-KS.
  
  
  METHODS
  A total of 378 blood samples were obtained from 62 patients with AIDS-KS followed longitudinally. All patients received antiretroviral therapy (ART) or anti-neoplastic therapy. The patients were divided into four groups according to their clinical status: onset disease (OD), progressive disease (PD), stable or partial remission (S/PR) and complete remission (CR).
  
  
  RESULTS
  Plasma HHV-8 DNAaemia was detected in all samples obtained from patients with OD or PD (100%); in contrast, HHV-8 DNAaemia was found only in a minority of patients with CR (8%) and was invariably undetectable in patients with stable CR. HHV-8 DNA detection in plasma was strongly associated with an unfavourable outcome (odds ratio=231.9; p<0.0001). Conversely, neither the HIV-1 viral load nor peripheral CD4(+) T-cell counts were associated with the KS clinical status, though both parameters did affect HHV-8 DNAaemia levels (p<0.0001). Multivariate analysis confirmed that HHV-8 DNAaemia was strongly and independently correlated with both clinical status (p<0.05) and HIV-1 plasma viraemia (p=0.027).
  
  
  CONCLUSIONS
  The strong association of plasma HHV-8 DNAaemia with onset or progressive disease is compatible with an active role of replicating virus in clinically active AIDS-KS. An accurate evaluation of the plasma HHV-8 load might be useful for monitoring AIDS-KS under antiretroviral or antineoplastic therapy.
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Monza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Broccolo
authors.affiliation: Division of Infectious and Tropical Diseases, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Tassan Din
authors.affiliation: Division of Oncology, Milano, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Viganò
authors.affiliation: Unit Human Virology, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rutigliano
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD 20892, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Lusso
authors.affiliation: Division of Infectious and Tropical Diseases, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tambussi
authors.affiliation: Unit Human Virology, San Raffaele Scientific Institute, Milan, Italy. Electronic address: mauro.malnati@hsr.it.
authors.forename: Mauro S
authors.initials: MS
authors.lastname: Malnati
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D004261:DNA Replication; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D005260:Female; D019288:Herpesvirus 8, Human / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000473:pathology* / Q000821:virology*; D019562:Viral Load; D014766:Viremia; D014779:Virus Replication
chemical_list: D004279:DNA, Viral
keywords: Disease progression; Human herpesvirus-8; Kaposi’s sarcoma; Plasma viraemia