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Lytic KSHV infections can contribute to severe inflammatory symptoms and KSHV-associated pathogenesis. We have previously reported on KSHV reactivation upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in a non-hospitalised cohort of people living with HIV (PLWH). From this cohort, we identified a 34-year-old male who presented for routine HIV care in May 2021 with an unusually high KSHV viral load (VL) of 189,946.3 copies\/106 cells, before SARS-CoV-2 infection. The patient was invited into a 2-year follow-up study where his peripheral blood was analysed for selected virological, clinical, and inflammatory parameters every 6 months. He remained highly viremic for KSHV throughout the 2-year study period, during which he was infected with SARS-CoV-2 and developed disseminated tuberculosis, with steadily increasing levels of the inflammatory markers C-reactive protein (CRP), and interleukin-6 (IL-6). His HIV VL remained controlled (&lt;1000 copies\/mL) and his CD4 count bordered immunosuppression (\u00b1200 cells\/\u00b5L), suggesting some responsiveness to antiretroviral treatment (ART). However, the patient\u2019s uncontrolled lytic KSHV infection may increase his risk for developing a KSHV-associated pathology manifesting with inflammation which should be closely monitored beyond the study period.<\/jats:p>","DOI":"10.3390\/tropicalmed10020053","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T11:54:06Z","timestamp":1739274846000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Persistent KSHV Viremia in the Context of HIV, SARS-CoV-2, and Other Co-Infections"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1765-8137","authenticated-orcid":false,"given":"Humaira","family":"Lambarey","sequence":"first","affiliation":[{"name":"International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa"},{"name":"Institute of Infectious Disease and Molecular Medicine (IDM), 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