Castleman disease and infection of Epstein Barr virus in a patient with HIV infection

Abstract

Castleman's disease (CD) is a lymphoproliferative disorder with an unfavorable prognosis, which has been associated with human herpes virus 8 (HHV-8) infection. The presumed mechanism of action of HHV- 8 would be the secretion of viral interleukin (IL), homologous to human IL such as IL-6 and IL-10. The co-HHV8 infection and Epstein Barr virus (EBV) is well known in patients infected with the HIV type 1 (HIV-1). These gamma-herpesvirus were associated with lymphoproliferative disorders that are favored by immunosuppression. It can occur in the context of a patient's good immune system and its treatment is based on the use of chemotherapy. Reactivation of latent EBV is favored by HIV-1 and the use of immunosuppressive drugs, determining a potential risk for the development of new lymphoproliferative disorders.
We report here a patient with Castleman's disease associated with HIV- 1 and HHV-8, who presented, as a complication of the chemotherapy, the reactivation of EBV infection. A review of the concept of CD and the pathogenic relationship between HIV-1, HHV-8 and EBV virus was performed.