Fig 1. Relationships between circulating HHV8 DNA, Kaposi sarcoma (KS), and lymphocyte phenotypes in individuals with HIV-1 and concomitant malignancy.

(A) Plasma and CD4⁺ T cell-depleted PBMC-associated HHV8 DNA are significantly and positively correlated by Spearman rank correlation analysis. (B) Individuals with clinical KS have higher plasma HHV8 DNA levels than those with other malignancies and evidence of prior HHV8 exposure (e.g. positive HHV8-specific antibodies or detectable HHV8 DNA), but there were no overall significant differences between pre- or post-chemotherapy time points by unpaired Mann Whitney U analysis. (C) Two individuals experienced >1-log₁₀ increase in HHV8 DNA following treatment for KS or allogeneic stem cell transplantation for lymphoma. (D) No differences in CD4⁺ T cell counts or percentages were identified between participants with and without detectable circulating HHV8 DNA, despite significantly lower CD4⁺ T cell counts and percentages in individuals with clinical KS (E). Individuals with circulating HHV8 had significantly increased expression of CD69 (early activation marker) on both CD4⁺ and CD8⁺ T cells (F), but no differences in late markers of activation (G) or proliferation (H). (I) Significantly higher numbers of CD4⁺ T cells expressed CD57 (lymphocyte exhaustion marker) from individuals with circulating HHV8. P values calculated from Mann Whitney U analyses and data points represent all sample time points from all participants. HSCT = hematopoietic stem cell transplantation.