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Plasma HHV8 DNA predicts relapse in individuals with HIV-associated multicentric Castleman disease.

Abstract
HIV-associated multicentric Castleman disease (HIV-MCD) is a rare lymphoproliferative disorder caused by infection with human herpesvirus-8. The disease follows a relapsing and remitting clinical course, with marked systemic symptoms during an active attack, which can prove fatal. Its incidence is rising, and new data indicate the utility of the anti-CD20 monoclonal antibody rituximab at inducing remissions in both first- and second-line settings, although biomarkers associated with relapse have not been previously identified. In 52 individuals with a histologic diagnosis of HIV-MCD, we performed univariate and multivariate analyses to predict factors associated with an HIV-MCD attack. Although a younger age (< 50 years) was associated with an attack, the strongest association was observed with plasma levels of human herpesvirus-8 DNA. Rising levels predicted an attack (hazard ratio = 2.9; 95% confidence interval, 1.3-6.7), and maintenance therapy with rituximab should be considered in these individuals.
AuthorsJustin Stebbing, Caroline Adams, Adam Sanitt, Salvinia Mletzko, Mark Nelson, Brian Gazzard, Tom Newsom-Davis, Mark Bower
JournalBlood (Blood) Vol. 118 Issue 2 Pg. 271-5 (Jul 14 2011) ISSN: 1528-0020 [Electronic] United States
PMID21511959 (Publication Type: Evaluation Study, Journal Article)
Chemical References
  • Biomarkers
  • DNA, Viral
Topics
  • AIDS-Related Opportunistic Infections (blood, diagnosis, virology)
  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active
  • Biomarkers (analysis, blood)
  • Castleman Disease (blood, diagnosis, etiology, virology)
  • DNA, Viral (blood, isolation & purification)
  • Female
  • Follow-Up Studies
  • HIV Infections (complications, diagnosis, drug therapy, virology)
  • Herpesviridae Infections (blood, complications, diagnosis, virology)
  • Herpesvirus 8, Human (genetics, isolation & purification)
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Recurrence
  • Young Adult

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