PMID- 20583924
OWN - NLM
STAT- MEDLINE
DCOM- 20101104
LR  - 20211028
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Print)
IS  - 1058-4838 (Linking)
VI  - 51
IP  - 3
DP  - 2010 Aug 1
TI  - An interleukin-6-related systemic inflammatory syndrome in patients co-infected 
      with Kaposi sarcoma-associated herpesvirus and HIV but without Multicentric 
      Castleman disease.
PG  - 350-8
LID - 10.1086/654798 [doi]
AB  - 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.
FAU - Uldrick, Thomas S
AU  - Uldrick TS
AD  - HIV and AIDS Malignancy Branch, National Cancer Institute-Frederick, Frederick, 
      MD, USA.
FAU - Wang, Victoria
AU  - Wang V
FAU - O'Mahony, Deirdre
AU  - O'Mahony D
FAU - Aleman, Karen
AU  - Aleman K
FAU - Wyvill, Kathleen M
AU  - Wyvill KM
FAU - Marshall, Vickie
AU  - Marshall V
FAU - Steinberg, Seth M
AU  - Steinberg SM
FAU - Pittaluga, Stefania
AU  - Pittaluga S
FAU - Maric, Irina
AU  - Maric I
FAU - Whitby, Denise
AU  - Whitby D
FAU - Tosato, Giovanna
AU  - Tosato G
FAU - Little, Richard F
AU  - Little RF
FAU - Yarchoan, Robert
AU  - Yarchoan R
LA  - eng
GR  - HHSN261200800001C/RC/CCR NIH HHS/United States
GR  - HHSN261200800001E/CA/NCI NIH HHS/United States
GR  - Z01 BC010888-01/ImNIH/Intramural NIH HHS/United States
GR  - ZIA BC010888-02/ImNIH/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Interleukin-6)
RN  - 0 (Viral Proteins)
RN  - 130068-27-8 (Interleukin-10)
SB  - IM
MH  - Adult
MH  - Castleman Disease/*complications/immunology
MH  - HIV/immunology
MH  - HIV Infections/*complications/immunology/virology
MH  - Herpesvirus 8, Human/immunology
MH  - Humans
MH  - Interleukin-10/blood
MH  - Interleukin-6/blood/*immunology
MH  - Middle Aged
MH  - Sarcoma, Kaposi/*complications/immunology/virology
MH  - Systemic Inflammatory Response Syndrome/*pathology
MH  - Viral Load
MH  - Viral Proteins/blood/*immunology
PMC - PMC2946207
MID - NIHMS203571
COIS- Potential Conflicts of Interest. G.T. is a co-inventor on a patent describing the 
      measurement of KSHV vIL-6. This invention was made when G.T. was an employee of 
      the US Government under 45 Code of Federal Regulations Part 7. All rights, title, 
      and interest to this patent have been assigned to the U.S. Department of Health 
      and Human Services. The government conveys a portion of the royalties it receives 
      to its employee inventors under the Federal Technology Transfer Act of 1986 (P.L. 
      99-502). R.Y is the spouse of G.T. All other authors: no conflicts.
EDAT- 2010/06/30 06:00
MHDA- 2010/11/05 06:00
PMCR- 2011/08/01
CRDT- 2010/06/30 06:00
PHST- 2010/06/30 06:00 [entrez]
PHST- 2010/06/30 06:00 [pubmed]
PHST- 2010/11/05 06:00 [medline]
PHST- 2011/08/01 00:00 [pmc-release]
AID - 10.1086/654798 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2010 Aug 1;51(3):350-8. doi: 10.1086/654798.