11/31. Varicella infection in a pediatric AIDS patient presenting as umbilicated papules.An 8-year-old girl with acquired immunodeficiency syndrome presented with fever and alteration of consciousness. She had a history of persistent cryptococcal meningitis. She developed multiple discrete umbilicated papules that resembled cutaneous cryptococcosis on the second day of admission. skin biopsy revealed an ulcer with a wedge-shaped necrosis of the dermis. The edge of the ulcer showed intracellular edema, margination of nucleoplasm and multinucleated cells, consistent with herpes infection. The diagnosis of varicella-zoster virus infection was confirmed by the identification of herpesvirus dna from the lesion and differentiation from other herpesviruses by restriction fragment length polymorphism (RFLP) method. Intravenous acyclovir was given at a dose of 500 mg/m2, three times daily for 14 days which resulted in resolution of the skin lesions within 2 weeks.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
12/31. Rapidly progressive human herpesvirus 8-associated solid anaplastic lymphoma in a patient with AIDS--associated Kaposi sarcoma.We report a case of rapidly progressive solid lymphoma with anaplastic large cell morphology, followed by systemic Kaposi sarcoma in an adult patient with AIDS. The lymphoma cells expressed human herpesvirus 8 (HHV-8)-encoded latent and lytic proteins and Epstein-Barr virus-encoded small rna, suggesting that this case could be categorized into HHV-8-associated solid lymphoma, a recently identified disease entity.- - - - - - - - - - ranking = 2.5keywords = herpesvirus (Clic here for more details about this article) |
13/31. Resolution of AIDS-related Castleman's disease with anti-CD20 monoclonal antibodies is associated with declining IL-6 and TNF-alpha levels.A 32-year-old hiv-1 positive man was diagnosed with Castleman's disease following a long history of constitutional symptoms. Primary therapy with single agent rituximab was associated with a near complete response. During this time, his KSHV (Kaposi's sarcoma-associated herpesvirus) viral load decreased and we also observed immediate, large and sustained decreases in interleukin-6 (IL-6) and tumor necrosis factor-alpha levels (TNF-alpha). This highlights the close association between circulating cytokines such as IL-6 and virally-induced malignancy.- - - - - - - - - - ranking = 0.5keywords = herpesvirus (Clic here for more details about this article) |
14/31. viral load of human herpesvirus 8 (HHV-8) in the circulatory blood cells correlates with clinical progression in a patient with HHV-8-associated solid lymphoma with aids-associated Kaposi's sarcoma.We encountered a case of a rapidly progressive HHV-8-associated solid lymphoma with AIDS-associated Kaposi's sarcoma (KS). HHV-8 dna load in whole blood cells was analyzed quantitatively by real-time PCR using amplification of the HHV-8-encoded ORF26 gene. Ours is the first observation that the rapid increase in the HHV-8 viral load (from 1.9x10(4) copies/microg to 1.6x10(6) copies/microg in 40 days) in conjunction with low CD4 cell counts was accompanied by an accelerated clinical disease progression. The results indicate that the quantity of circulating HHV-8 is measurable with real-time PCR and can provide clinically useful information.- - - - - - - - - - ranking = 2keywords = herpesvirus (Clic here for more details about this article) |
15/31. Kaposi's sarcoma-associated herpesvirus/human herpesvirus type 8-positive solid lymphomas: a tissue-based variant of primary effusion lymphoma.Kaposi's sarcoma-associated herpesvirus (KSHV), also termed human herpesvirus type 8, is consistently identified in Kaposi's sarcoma, primary effusion lymphoma (PEL), and multicentric Castleman's disease. Here we report four cases of KSHV-bearing solid lymphomas that occurred in AIDS patients (cases 1 to 3) and in a human immunodeficiency virus (HIV)-seronegative person (case 4). The patients presented extranodal masses in the abdomen (cases 1, 3, and 4) or skin (case 2), and nodal involvement, together with Kaposi's sarcoma (case 3). The gastrointestinal tract was involved in two patients (cases 1 and 3). The patients did not develop a lymphomatous effusion. KSHV was detected in the tumor cells of all cases by immunohistochemistry and by polymerase chain reaction. Epstein-Barr virus was detected in two of the HIV-related cases. All KSHV-positive solid lymphomas exhibited PEL-like cell morphology. To investigate the relationship of these disorders to PEL and to other AIDS-associated diffuse large cell lymphomas, KSHV-positive solid lymphomas were tested for the expression of a set of genes that were previously shown by gene profiling analysis to define PEL tumor cells. The results showed that expression of this set of genes in KSHV-positive lymphomas is similar to that of PEL but distinct from KSHV-negative AIDS-associated diffuse large cell lymphomas. Because pathobiological features of KSHV-positive solid lymphomas closely mimic those of PEL, our results suggest that KSHV-positive solid lymphomas should be considered as a tissue-based variant of classical PEL, irrespective of HIV status.- - - - - - - - - - ranking = 5keywords = herpesvirus (Clic here for more details about this article) |
16/31. Recurrent and self-healing cutaneous monoclonal plasmablastic infiltrates in a patient with AIDS and Kaposi sarcoma.Infection with human immunodeficiency virus (HIV) increases the risk of developing non-Hodgkin lymphoma. Plasmablastic lymphoma (PBL) is a rare variant of diffuse large cell lymphoma that often involves the oral cavity of HIV patients. It is characterized by immunoblastic morphology and plasma cell phenotype. Cutaneous involvement in PBL appears to be rare. We report a 44-year-old man with AIDS and Kaposi sarcoma (KS) previously treated with doxorubicin who, following treatment with highly active antiretroviral therapy, developed an erythematous infiltrated nodule on the right arm. histology showed subcutaneous fat necrosis and clusters of atypical large plasma cells (plasmablastic cells). immunohistochemistry revealed lambda light chain restriction. Epstein-Barr virus (EBV) mRNA was detected by in situ hybridization within the plasmablastic cells. polymerase chain reaction amplification with specific primers for human herpesvirus 8 (HHV-8) performed on the skin biopsy specimen detected a specific band. A complete screening (bone marrow biopsy, computed tomographic scan, radiological survey) disclosed no abnormalities. The lesion resolved spontaneously after 3 months. Two years later an infiltrated plaque developed on the abdominal wall. The clinical and histopathological features of this new lesion were similar to those observed 2 years previously. No evidence of extracutaneous involvement was detected. The lesion again resolved spontaneously after 25 days. PBL may be seen in patients with transplants or receiving chemotherapy, but is usually observed in patients with advanced AIDS. The observation of recurrent self-healing EBV- and HHV-8-associated cutaneous monoclonal plasmablastic infiltrates, in a patient with AIDS and KS, expands the clinical spectrum of AIDS-associated plasmablastic lymphoproliferative disorders.- - - - - - - - - - ranking = 0.5keywords = herpesvirus (Clic here for more details about this article) |
17/31. Human herpesvirus-8 in Kaposi's sarcoma of the conjunctiva in a patient with AIDS.PURPOSE: To demonstrate human herpesvirus-8 (HHV-8) in Kaposi's sarcoma (KS) of the conjunctiva in a patient with acquired immunodeficiency syndrome (AIDS). methods: Clinical observation, pathologic findings of conjunctival specimens, immunohistochemical staining for HHV-8-specific antigen, polymerase chain reaction (PCR) analysis of HHV-8 dna, and detection of specific antibody in patient's serum at appropriate times. RESULTS: In the conjunctival specimen, swollen endothelial-like cells were found with slit-like vessels. CD 31-positive cells were noted on the inner surface of the slit-like vessels, and HHV-8 latency-associated nuclear antigen was detected. The presence of HHV-8 dna was demonstrated by PCR. Anti-HHV-8 antibody was found in the patient's serum. CONCLUSIONS: This is the first case report in the ophthalmology literature that provides histological, dna, and serological evidence that HHV-8 is involved in the pathogenesis of conjunctival KS.- - - - - - - - - - ranking = 2.5keywords = herpesvirus (Clic here for more details about this article) |
18/31. Differences in the frequency and function of HHV8-specific CD8 T cells between asymptomatic HHV8 infection and Kaposi sarcoma.It is unclear how the immune response controls human herpesvirus 8 (HHV8; also known as Kaposi sarcoma-associated herpesvirus [KSHV]) replication and thereby prevents Kaposi sarcoma (KS). We compared CD8 T-cell responses to HHV8 latent (K12) and lytic (glycoprotein B, ORF6, ORF61, and ORF65) antigens in patients who spontaneously controlled the infection and in patients with posttransplantation, AIDS-related, or classical KS. We found that anti-HHV8 responses were frequent, diverse, and strongly differentiated toward an effector phenotype in patients who controlled the infection. Conversely, HHV8-specific CD8 cells were very rare in patients who progressed to KS, and were not recruited to the tumoral tissue, as visualized by in situ tetramer staining of KS biopsies. Last, HHV8-specific CD8 T cells were observed in a seronegative recipient of an HHV8infected graft who remained persistently aviremic and antibody negative, suggesting that specific cytotoxic T lymphocytes (CTLs) may provide protection from persistent HHV8 infection. These results support the crucial role of cellular immune responses in controlling HHV8 replication, in preventing malignancies in latently infected subjects, and in conferring genuine resistance to persistent infection. They may also have important implications for the design of prophylactic and therapeutic HHV8 vaccines, and for adoptive immunotherapy of KS.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
19/31. Rapidly progressive outer retinal necrosis in the acquired immunodeficiency syndrome.Two patients, both seropositive for the human immunodeficiency virus, developed rapidly progressive retinal necrosis associated with a systemic herpes zoster infection. The retinitis in these patients was characterized by primary involvement of the outer retina, with sparing of the inner retina and retinal vasculature until late in the disease process; a rapidly progressive course; poor response to intravenous acyclovir; and development of rhegmatogenous retinal detachment. In one of the patients, the retinitis was initially multifocal. Electron microscopy of a retinal biopsy specimen from one of the patients demonstrated virus particles consistent with a herpesvirus, and polymerase chain reaction disclosed herpesvirus in a retinal biopsy specimen of the other patient. This entity may represent a distinct form of acute retinal necrosis that is seen in immunocompromised individuals.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
20/31. Disseminated ecthymatous herpes varicella-zoster virus infection in patients with acquired immunodeficiency syndrome.Herpesvirus infections are among the most common and debilitating opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS), and they may have atypical clinical features. We describe the cases of three patients with AIDS in whom atypical persistent ulcerative skin lesions developed as a result of varicella-zoster virus infection. Two patients had disseminated infection without a vesicular stage; one patient had underlying asteatotic eczema. All responded well to acyclovir. One patient was treated with azidothymidine, and typical dermatomal herpes zoster subsequently developed. The profound loss of helper T cell function in AIDS may lead to multiple abnormalities in local immune response to cutaneous herpesvirus infections and may be responsible for the atypical morphology and a prolonged course.- - - - - - - - - - ranking = 0.5keywords = herpesvirus (Clic here for more details about this article) |
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