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.
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Authors | Justin Stebbing, Caroline Adams, Adam Sanitt, Salvinia Mletzko, Mark Nelson, Brian Gazzard, Tom Newsom-Davis, Mark Bower |
Journal | Blood
(Blood)
Vol. 118
Issue 2
Pg. 271-5
(Jul 14 2011)
ISSN: 1528-0020 [Electronic] United States |
PMID | 21511959
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
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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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