High-level human herpesvirus-8 viremia and multicentric Castleman's disease following initiation of highly active antiretroviral therapy

摘要

We present a series of three men with a median age of 52 years (45-54) with HIV-related multicentric Castleman's disease (HIV-MCD) presenting after the initiation of highly active antiretroviral therapy (HAART). The presentations occurred at a median 3.5 months (range 3-8 months) following HAART initiation (two patients were HAART-naive and one was re-commencing HAART after a period of nonadherence). All had a good virological response to HAART (Fig. 1). The baseline CD4+ cell count was a median of 92 x 106/l (range 10-148 x 106/l). Each presented with a systemic inflammatory response syndrome and had widespread lymphadenopathy on computed tomography (CT) scan that was fluorodeoxyglucose-avid on PET scan. Lymph node biopsy confirmed human herpesvirus-8 (HHV-8)-positive MCD in each case. All men had HHV-8 viremia detected at baseline (retrospective testing) and had extremely high HHV-8 viral loads at MCD presentation, median 9.8 x 106 copies/ml (7.7-13.3 X 106copies/ml) (Fig. 1).