Elevated virus loads of Kaposi's sarcoma-associated human herpesvirus 8 predict Kaposi's sarcoma disease progression, but elevated levels of human immunodeficiency virus type 1 do not

• Published in: The Journal of infectious diseases 2002-06, Vol.185 (12), p.1736-1744
• Main Authors: Quinlivan, E. Byrd, Zhang, Chuan, Stewart, Paul W., Komoltri, Chulaluk, Davis, Michelle G., Wehbie, Robert S.
• Format: Article
• Language: English
• Subjects: Adult; AIDS; Biological and medical sciences; CD4-Positive T-Lymphocytes; Cells, Cultured; Dermatology; Disease Progression; DNA; Herpesviridae; Herpesvirus 8, Human; HIV; HIV-1; Human herpesvirus 8; Humans; Kaposi sarcoma; Major Articles; Male; Medical sciences; Plasmids; Polymerase Chain Reaction; Predictive Value of Tests; Sarcoma, Kaposi - virology; T lymphocytes; Tumors of the skin and soft tissue. Premalignant lesions; Viral Load; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/340652

Kaposi's sarcoma-associated herpesvirus (KSHV) is found in Kaposi's sarcoma (KS), multicentric Castleman's disease, and primary effusion lymphomas. To prospectively evaluate KSHV load as a biomarker for KS clinical status and prognosis in a cohort of men with AIDS-related KS, 2 quantitative polymerase chain reaction (PCR) assays were developed and tested to determine KSHV peripheral blood mononuclear cell (PBMC) virus loads. Most patients (13/15) with good-prognosis KS had ⩽ 1.5 log KSHV copies/105 PBMC by both quantitative competitive (QC) and real-time Applied Biosystems (ABI) PCR. Both assays provided 94% specificity for identifying the 16 patients without KS progression during 20 months of follow-up. QC-PCR and ABI-PCR exhibited 100% and 80% levels of diagnostic sensitivity, respectively, for identifying the 5 patients whose KS progressed. Neither dichotomized human immunodeficiency virus loads nor dichotomized CD4 counts predicted either KS progression or KS clinical stage (all positive predictive values < 30%). These results are evidence that the quantity of circulating KSHV in KS patients is biologically meaningful and is measurable with sufficient accuracy to provide clinically useful information.