Epstein-Barr virus- and Kaposi sarcoma-associated herpesvirus-related malignancies in the setting of human immunodeficiency virus infection

The human gammaherpesvirus family includes Epstein-Barr virus (EBV) and human herpesvirus (HHV)-8, also known as Kaposi sarcoma-associated herpesvirus (KSHV). In human immunodeficiency virus (HIV)-infected patients, both EBV and KSHV have been implicated in the development of a wide range of tumors. KSHV-associated diseases include Kaposi sarcoma (KS), primary effusion lymphoma (PEL), and multicentric Castleman disease (MCD). EBV has been associated with the development of several malignancies, including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The introduction of highly active antiretroviral therapy (HAART) has dramatically modified the natural history of HIV infection, causing a decline in the incidence of acquired immunodeficiency syndrome (AIDS)-defining malignancies, including KS. However, it has had a less favorable impact on EBV-related malignancies and NHLs remain the most common tumors in the HAART era. In this review, we briefly summarize the pathogenesis, epidemiology, clinical features, and therapeutic approach to EBV- and KSHV-associated tumors in the setting of HIV infection.