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 often associated with human immunodeficiency virus type 1 (HIV-1) infection. Recent case reports have indicated resolution of KS and clearance of HHV-8 DNA from peripheral blood mononuclear cells (PBMC) in HIV-1-infected subjects following highly effective antiretroviral therapy, including HIV-1 protease inhibitors (PI), suggesting a possible activity for these compounds on HHV-8 replication. In the present study, the time course of PBMC HHV-8 DNA levels, plasma HIV-1 RNA load, and CD4+ T-cell counts were followed up in six coinfected subjects (four with and two without KS) under antiretroviral therapy with PI. A specific anti-HHV-8 role for PI was not consistently found, since fluctuation of HHV-8 viral load over time appeared to be independent of treatment. Nevertheless, our data support the hypothesis that KS patients may significantly benefit from PI therapy as an indirect consequence of partial restoration of immune functions following effective anti-HIV-1 combination therapy.