Antiretroviral therapy with protease inhibitors in human immunodeficiency virus type 1- and human herpesvirus 8-coinfected patients

Human herpesvirus 8 (HHV-8) is believed to play a role in the pathogenesis of Kaposi's sarcoma (KS) and possibly in other proliferative disorders ofte n associated with human immunodeficiency virus type 1 (HIV-1) infection. Re cent case reports have indicated resolution of KS and clearance of HHV-8 DN A from peripheral blood mononuclear cells (PBMC) in HIV-1-infected subjects following highly effective antiretroviral therapy, including HIV-1 proteas e inhibitors (PI), suggesting a possible activity for these compounds on HH V-8 replication. In the present study, the time course of PBMC HHV-8 DNA le vels, plasma HIV-1 RNA load, and CD4(+) T-cell counts were followed up in s ix coinfected subjects (four with and two without KS) under antiretroviral therapy with PI. A specific anti-HHV-8 role for PI was not consistently fou nd, since fluctuation of HHV-8 viral load over time appeared to be independ ent of treatment. Nevertheless, our data support the hypothesis that KS pat ients may significantly benefit from PI therapy as an indirect consequence of partial restoration of immune functions following effective anti-HIV-l c ombination therapy. (C) 1999 Wiley-Liss, Inc.