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Use of plasma human herpesvirus-8 viral load measurement: evaluation of practice in three UK HIV treatment centres

By: Contributor(s): Publication details: 2017Uniform titles:
  • International Journal of STD & AIDS
Online resources: Summary: <span style="font-size: 10pt;">A retrospective audit of&nbsp;<span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">plasma</span>&nbsp;human herpesvirus-8 (HHV-8) viral load testing was performed in three HIV treatment centres over 24 months. Reasons for testing (360 tests) were: symptoms of systemic inflammatory response syndrome (SIRS) (fever, lymphadenopathy and raised inflammatory markers); monitoring in known HHV-8 pathology other than Kaposi sarcoma (KS); investigation of known/suspected KS, and other/no reason. Of patients with multicentric Castleman disease (MCD), 14/16 (88%) had detectable&nbsp;<span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">plasma</span>&nbsp;HHV-8, as did 27/45 (60%) with biopsy proven or clinically confirmed KS, and 6/19 (32%) with lymphoma. Neither of the two patients with MCD and no detectable HHV-8 had SIRS symptoms at the time of the test. There was wide variation between centres in the indications prompting HHV-8 testing, with a more conservative approach resulting in a higher proportion of positive results. Measuring&nbsp;<span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">plasma</span>&nbsp;HHV-8 in the absence of SIRS symptoms, established HHV-8 disease monitoring, or confirmed/suspected KS is unlikely to yield detectable HHV-8 thus allowing potential cost savings.</span>
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&lt;span style="font-size: 10pt;"&gt;A retrospective audit of&amp;nbsp;&lt;span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;"&gt;plasma&lt;/span&gt;&amp;nbsp;human herpesvirus-8 (HHV-8) viral load testing was performed in three HIV treatment centres over 24 months. Reasons for testing (360 tests) were: symptoms of systemic inflammatory response syndrome (SIRS) (fever, lymphadenopathy and raised inflammatory markers); monitoring in known HHV-8 pathology other than Kaposi sarcoma (KS); investigation of known/suspected KS, and other/no reason. Of patients with multicentric Castleman disease (MCD), 14/16 (88%) had detectable&amp;nbsp;&lt;span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;"&gt;plasma&lt;/span&gt;&amp;nbsp;HHV-8, as did 27/45 (60%) with biopsy proven or clinically confirmed KS, and 6/19 (32%) with lymphoma. Neither of the two patients with MCD and no detectable HHV-8 had SIRS symptoms at the time of the test. There was wide variation between centres in the indications prompting HHV-8 testing, with a more conservative approach resulting in a higher proportion of positive results. Measuring&amp;nbsp;&lt;span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;"&gt;plasma&lt;/span&gt;&amp;nbsp;HHV-8 in the absence of SIRS symptoms, established HHV-8 disease monitoring, or confirmed/suspected KS is unlikely to yield detectable HHV-8 thus allowing potential cost savings.&lt;/span&gt;

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