Castleman disease

Christopher Hoffmann, M.D., M.P.H., Mark Levis, M.D., Ph.D.
Castleman disease is a topic covered in the Johns Hopkins HIV Guide.

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PATHOGENS

  • HIV-associated multicentric Castleman disease (MCD) always associated with HHV-8, aka Kaposi sarcoma-associated herpesvirus (KSHV). HHV-8 present in 40% of non-HIV cases.
  • HHV-8 is a double-stranded DNA gamma-herpesvirus.
  • MCD is likely the result of active lytic infection with all viral genes expressed and viral replication as opposed to a very small proportion of HHV-8 cells (1%) having lytic infection in Kaposi sarcoma.
  • HHV-8 is secreted in saliva (possible reason for high MSM prevalence of HHV-8 infection in the U.S. is through oral anal infection, unclear reasons for high general population infection in Africa).

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PATHOGENS

  • HIV-associated multicentric Castleman disease (MCD) always associated with HHV-8, aka Kaposi sarcoma-associated herpesvirus (KSHV). HHV-8 present in 40% of non-HIV cases.
  • HHV-8 is a double-stranded DNA gamma-herpesvirus.
  • MCD is likely the result of active lytic infection with all viral genes expressed and viral replication as opposed to a very small proportion of HHV-8 cells (1%) having lytic infection in Kaposi sarcoma.
  • HHV-8 is secreted in saliva (possible reason for high MSM prevalence of HHV-8 infection in the U.S. is through oral anal infection, unclear reasons for high general population infection in Africa).

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Last updated: January 5, 2017