Blaison F, Galtier J, Parrens M, Viallard J-F, Boutboul D
Service de médecine interne et maladies infectieuses, centre de compétence de la maladie de Castleman, hôpital Haut Lévêque CHU de Bordeaux, 33600 Pessac, France.
Service d'hématologie et de thérapie cellulaire, hôpital Haut Lévêque CHU de Bordeaux, 33600 Pessac, France.
Rev Med Interne. 2022 May;43(5):301-311. doi: 10.1016/j.revmed.2021.10.004. Epub 2021 Dec 9.
HHV-8 is an oncogenic Gammaherpesvirinae discovered in 1994 during the HIV pandemic. It is the causative agent of Kaposi's sarcoma, and is also associated with the occurrence of several aggressive B lymphoproliferative disorders. Most of them occur in an immunosuppression setting, usually due to HIV infection. Multicentric HHV8-associated Castleman's disease and KSHV Inflammatory Cytokine Syndrome (KICS) are primarily reactive entities with prominent systemic features. They illustrate the cytokinic storm induced by HHV-8 in its cell host. On the other hand, HHV-8 can drive proliferation and lymphomagenesis of its plasmablastic cell host, and is associated with a risk to develop aggressive lymphomas with plasmacytic differenciation. Primary effusion lymphoma usually localizes in body cavities and may affect other extra-nodal sites ; its prognostic is poor. Diffuse large B-cell lymphoma HHV-8, NOS affect more commonly nodes and blood and evolve from infected cell of HHV-8 associated Castleman disease. On the contrary, germinotropic lymphoproliferative disorders presents mainly as localized adenopathy with indolent course, and show polyclonality. Histology plays a key role in distinguishing these different entities and need expert reviewing, especially since they may be associated with each other. Besides lymphoproliferative disorders, HHV8 is associated with various hematological manifestations. The aim of this review is to provide an update on the presentation, diagnosis, and management of immunologic and hematologic complications associated with HHV-8.
人类疱疹病毒8型（HHV-8）是1994年在艾滋病大流行期间发现的一种致癌性γ疱疹病毒亚科病毒。它是卡波西肉瘤的病原体，还与几种侵袭性B淋巴细胞增殖性疾病的发生有关。其中大多数发生在免疫抑制环境中，通常是由于HIV感染。多中心HHV8相关的卡斯尔曼病和卡波西肉瘤疱疹病毒炎性细胞因子综合征（KICS）主要是具有突出全身特征的反应性疾病。它们说明了HHV-8在其细胞宿主中诱导的细胞因子风暴。另一方面，HHV-8可驱动其浆母细胞宿主的增殖和淋巴瘤发生，并与发生具有浆细胞分化的侵袭性淋巴瘤的风险相关。原发性渗出性淋巴瘤通常定位于体腔，可能影响其他结外部位；其预后较差。HHV-8弥漫性大B细胞淋巴瘤，NOS更常见于淋巴结和血液，由HHV-8相关的卡斯尔曼病感染细胞演变而来。相反，亲嗜性淋巴细胞增殖性疾病主要表现为局限性淋巴结病，病程缓慢，并显示多克隆性。组织学在区分这些不同实体方面起着关键作用，需要专家审查，特别是因为它们可能相互关联。除了淋巴细胞增殖性疾病外，HHV8还与各种血液学表现有关。本综述的目的是提供与HHV-8相关的免疫和血液学并发症的表现、诊断和管理的最新信息。
