HHV-8-Associated Hemophagocytic Lymphohistiocytosis in a HIV-Negative and Nontransplant Man: A Case Report and Literature Review.

Hemophagocytic lymphohistiocytosis (HLH) is a critical and life-threatening syndrome, which can rapidly progress to mortality without immediate or targeted therapeutic intervention. Human herpesvirus 8 (HHV-8, or Kaposi sarcoma-associated herpesvirus (KSHV)) is a rarely described viral cause of secondary HLH, especially in immunocompetent adults. Here, we report an uncommon case of HLH after HHV-8 infection, with no history of transplantation or HIV infection. The pathophysiological mechanisms of secondary HLH remain incompletely understood. There might be potential overlapping pathogenic pathways between HHV-8-associated HLH and KICS pathogenesis. E3 ubiquitin ligases may be a critical factor in the pathogenesis of HHV-8-associated secondary HLH. Ferritin testing, peripheral blood smears, and pathogenesis evaluations should be immediately implemented for patients presenting with fever and bicytopenia. Through our case report, we seek to advance clinical recognition of HHV-8-associated HLH, optimize diagnostic precision, and ultimately improve survival outcomes for patients.