Epstein-Barr Virus-Associated Smooth Muscle Tumor and Its Correlation With CD4 Levels in a Patient With HIV Infection.

Po-Liang Lu,Yoon Bin Chong,Hsin-Ling Yin,Chih-Hui Chang,Yu-Chun Ma

doi:10.3389/fcimb.2022.725342

Abstract

Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare tumor found in immunocompromised patients, and its treatment is not well-established. A role for antiretroviral therapy in human immunodeficiency virus (HIV)-related EBV-SMT has been proposed; however, the relevance of tumor size, CD4 levels, and immune reconstitution inflammatory syndrome (IRIS) has not been previously reported. We present the first case, to our knowledge, of a tumor that shrank in association with elevated CD4 counts. IRIS occurred in this case following antiretroviral therapy. This finding highlights the importance of the immune response in HIV-related EBV-SMT.

Highlights

The Epstein-Barr virus (EBV) is a human herpesvirus
We report a case with EBVSMT; the tumor shrank without surgery in close association with the CD4 count, and the phenomenon of immune reconstitution inflammatory syndrome (IRIS) was observed
The final diagnosis became apparent when the patient presented with paraplegia due to spinal cord compression caused by the thoracic tumor, and the pathology findings revealed that the smooth muscle tumor was an EBV-associated smooth muscle tumor (EBV-SMT) (Chiu et al, 2018)

Summary

INTRODUCTION

The Epstein-Barr virus (EBV) is a human herpesvirus. Its latent form is very common, and almost 95% of the human population has been infected (Yan et al, 2018). A 38-year-old male patient with a 12-year history of HIV and hepatitis B co-infection received initial antiretroviral therapy (ART) with lamivudine (3TC 150 mg Q12H; GlaxoSmithKline, Brentford, UK), stavudine (Zerit 40 mg Q12H; Emcure Pharmaceuticals, Pune, India), and efavirenz (Stocrit 600 mg QD; Merck, Kenilworth, NJ) He was not compliant with medical care and was lost to follow-up for 2 months. The fifth follow-up CT revealed that the T11 tumor shrank in size to 6 cm when the CD4 count reached 186 cells/μL, which was the highest value during his treatment. His numbness symptoms had improved at this point. The tumor remained stable for 1 year after surgery and remained under follow-up

DISCUSSION

CONCLUSION

Findings

ETHICS STATEMENT