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14th Annual Conference of the British HIV Association23-25 April 2008, Belfast |
PLASMA HHV8 DNA VIRAL LOAD AS A TUMOUR MARKER FOR MULTICENTRIC CASTLEMAN'S DISEASE (MCD)
HIV Med 2008 Apr 23-25 (Suppl 1);14:7 (abstract no. O25)
V Campbell, J Krell, M Stancliffe, M Atkins, M Nelson, M Habibi, B Gazzard and M Bower
Chelsea and Westminster Hospital, London, UK
BACKGROUND: MCD is a rare lymphoproliferative disorder occurring at increased incidence in people with HIV infection. Human herpesvirus-8 (HHV8) also known as Kaposi's sarcoma-associated herpes virus has a central role in pathogenesis of MCD. We evaluated the role of plasma HHV8 DNA quantification as a tumour marker in MCD.
METHODS: Plasma samples were obtained at diagnosis from 219 HIV positive people including 29 with MCD. A total of 180 plasma samples were obtained from patients with MCD at diagnosis, relapse and in remission. Plasma HHV8 DNA viral load was measured using Lightcycler quantitative polymerase chain reaction (PCR) (Roche, Lewis, UK) on DNA extracted from whole blood using primers specific to HHV8 ORF-7 gene.
RESULTS: In people with HIV, HHV8 DNA was detected at diagnosis in 25/29 (86%) patients with MCD, 25/67 (37%) with Kaposi sarcoma (KS), 2/70 (3%) with other malignancies and 0/53 with no malignancy. These results at diagnosis yield a specificity of 86%, sensitivity of 86%, positive predictive value of 40% and negative predictive value of 88%. When detected, the median HHV8 viral load at diagnosis in MCD was 41,000 copies/mL and in KS 3,900 copies/mL. During an attack of MCD (diagnosis or relapse), plasma HHV8 DNA was detectable in 67/75 (89%) samples and during remission was detectable in 30/105 (28%) samples (MW test p<0.0001). When detected, the median HHV8 viral load during an MCD attack was 30,000 copies/mL and during remission was 2,150 copies/mL.
CONCLUSION: Plasma HHV8 DNA viral load is useful in the diagnosis and monitoring of MCD.
2008-04-23
O25
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