1 Pulmonary manifestations of HHV-8 during HIV infection

Human herpes virus 8 (HHV-8) is an oncogenic gamma-herpes virus first described in 1994 in Kaposi sarcoma (KS) lesions. HHV-8 is involved in the pathophysiologic features of multicentric Castleman’s disease (MCD) and primary effusion lymphoma (PEL), both rare B-cell lymphoproliferative diseases. HHV-8–related tumours occur almost exclusively in immunocompromised patients, most with HIV infection. Combined antiretroviral therapies have reduced the incidence of KS but not MCD and PEL. HHV-8–related diseases frequently exhibit pulmonary involvement, which may indicate the disease. KS in the lung is often asymptomatic but may require specific therapy. It mostly shows cutaneous or mucosal involvement. Patients with typical MCD present fever and lymphadenopathy associated with interstitial lung disease without opportunistic infection. Specific treatment may be urgent. PEL provokes a febrile, lymphocytic-exudative pleural effusion, without pleural mass on CT scan. Rapid diagnosis prevents unnecessary exams and leads to specific, rapid treatment