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An Interleukin‐6–Related Systemic Inflammatory Syndrome in Patients Co‐Infected with Kaposi Sarcoma–Associated Herpesvirus and HIV but without Multicentric Castleman Disease

Open access
Uldrick, Thomas S., Wang, Victoria, O’Mahony, Deirdre, Aleman, Karen, Wyvill, Kathleen M., Marshall, Vickie, Steinberg, Seth M., Pittaluga, Stefania, Maric, Irina, Whitby, Denise, Tosato, Giovanna, Little, Richard F., Yarchoan, Robert·2010·Clinical Infectious Diseases
DOI 10.1086/654798
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Abstract

BACKGROUND: Kaposi sarcoma-associated herpesvirus (KSHV) is the causal agent for Kaposi sarcoma (KS) and multicentric Castleman disease (MCD) in human immunodeficiency virus (HIV)-infected patients. Patients with KSHV-MCD develop fevers, wasting, hypoalbuminemia, cytopenias, and hyponatremia that are related to overproduction of KSHV-encoded viral interleukin (IL)-6 (vIL-6) and human IL-6 (hIL-6). METHODS: We identified 6 HIV-infected patients with KS or serological evidence of KSHV infection who had severe inflammatory MCD-like symptoms but in whom we could not diagnose MCD, and we hypothesized that these symptoms resulted from vIL-6 overproduction. Serum vIL-6 levels were assessed in these 6 patients and compared with levels in 8 control patients with symptomatic KSHV-MCD and 32 control patients with KS. KSHV viral load, serum hIL-6 level, and human IL-10 level were also evaluated. RESULTS: Patients with inflammatory MCD-like symptoms but without MCD had elevated vIL-6 levels, comparable with levels in patients with symptomatic KSHV-MCD, and had levels that were significantly greater than those in control patients with KS (P = .003). Elevated hIL-6, IL-10, and KSHV viral loads were also comparable to patients with symptomatic KSHV-MCD and significantly greater than those with KS. CONCLUSIONS: A subset of patients with HIV and KSHV co-infection, but without MCD, can develop severe systemic inflammatory symptoms associated with elevated levels of KSHV vIL-6, IL-6, and KSHV viral loads. Excess lytic activation of KSHV, production of the lytic gene product vIL6, and associated immunologic dysregulation may underlie the pathophysiology of these symptoms. This IL-6-related inflammatory syndrome is important to consider in critically ill patients with HIV and KSHV co-infection.

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Metadata

Authors
Uldrick, T. S., Wang, V., O’Mahony, D., Aleman, K., Wyvill, K. M., Marshall, V., Steinberg, S. M., Pittaluga, S., Maric, I., Whitby, D., Tosato, G., Little, R. F., & Yarchoan, R.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2010-08
Volume
51
Issue
3
Pages
350-358
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/654798
OpenAlex
W2133064188
Cited by
304
References
32
FWCI
6.13
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: An Interleukin‐6–Related Systemic Inflammatory Syndrome in Patients Co‐Infected with Kaposi Sarcoma–Associated Herpesvirus and HIV but without Multicentric Castleman Disease. https://app.cochat.ai/papers/10.1086/654798
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Uldrick, T. S., Wang, V., O’Mahony, D., Aleman, K., Wyvill, K. M., Marshall, V., Steinberg, S. M., Pittaluga, S., Maric, I., Whitby, D., Tosato, G., Little, R. F., & Yarchoan, R. (2010). An Interleukin‐6–Related Systemic Inflammatory Syndrome in Patients Co‐Infected with Kaposi Sarcoma–Associated Herpesvirus and HIV but without Multicentric Castleman Disease. Clinical Infectious Diseases. https://doi.org/10.1086/654798

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.