Coinfection with Human Herpesvirus 8 Is Associated with Persistent Inflammation and Immune Activation in Virologically Suppressed HIV-Infected PatientsReportar como inadecuado

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Infection with co-pathogens is one of the postulated factors contributing to persistent inflammation and non-AIDS events in virologically-suppressed HIV-infected patients. We aimed to investigate the relationship of human herpesvirus-8 HHV-8, a vasculotropic virus implicated in the pathogenesis of Kaposi-s sarcoma, with inflammation and subclinical atherosclerosis in HIV-infected patients.


Prospective study including virologically suppressed HIV-infected patients. Several blood biomarkers highly-sensitive C-reactive protein hsCRP, tumour necrosis factor-α, interleukin-6, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1, intercellular cell adhesion molecule-1, malondialdehyde, plasminogen activator inhibitor PAI-1, D-dimer, sCD14, sCD163, CD4-CD38-HLA-DR, and CD8-CD38-HLA-DR, serological tests for HHV-8 and the majority of herpesviruses, carotid intima-media thickness, and endothelial function through flow-mediated dilatation of the brachial artery were measured.


A total of 136 patients were included, 34.6% of them infected with HHV-8. HHV-8-infected patients were more frequently co-infected with herpes simplex virus type 2 HSV-2 P<0.001, and less frequently with hepatitis C virus HCV P = 0.045, and tended to be older P = 0.086. HHV-8-infected patients had higher levels of hsCRP median interquartile range, 3.63 1.32–7.54 vs 2.08 0.89–4.11 mg-L, P = 0.009, CD4-CD38-HLA-DR 7.67% 4.10–11.86% vs 3.86% 2.51–7.42%, P = 0.035 and CD8-CD38-HLA-DR 8.02% 4.98–14.09% vs 5.02% 3.66–6.96%, P = 0.018. After adjustment for the traditional cardiovascular risk factors, HCV and HSV-2 infection, the associations remained significant: adjusted difference between HHV-8 positive and negative patients 95% confidence interval for hsCRP, 74.19% 16.65–160.13%; for CD4-CD38-HLA-DR, 89.65% 14.34–214.87%; and for CD8-CD38-HLA-DR, 58.41% 12.30–123.22%. Flow-mediated dilatation and total carotid intima-media thickness were not different according to HHV-8 serostatus.


In virologically suppressed HIV-infected patients, coinfection with HHV-8 is associated with increased inflammation and immune activation. This might contribute to increase the risk of non-AIDS events, including accelerated atherosclerotic disease.

Autor: Mar Masiá , Catalina Robledano, Victoria Ortiz de la Tabla, Pedro Antequera, Blanca Lumbreras, Ildefonso Hernández, Félix Guti



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