Plasma Epstein-Barr Virus Load as an Early Biomarker and Prognostic Factor of Human Immunodeficiency Virus–related Lymphomas

• Published in: Clinical infectious diseases Vol. 68; no. 5; pp. 834 - 843
• Main Authors: Muncunill, Josep, Baptista, Maria-Joao, Hernandez-Rodríguez, Águeda, Dalmau, Judith, Garcia, Olga, Tapia, Gustavo, Moreno, Miriam, Sancho, Juan-Manuel, Martínez-Picado, Javier, Feliu, Evarist, Mate, José-Luis, Ribera, Josep-Maria, Navarro, José-Tomás
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 15.02.2019
• Subjects: Adult; Aged; Aged, 80 and over; ARTICLES AND COMMENTARIES; Biomarkers - blood; Case-Control Studies; Female; Herpesvirus 4, Human; HIV Infections - blood; HIV Infections - complications; Humans; Lymphoma, AIDS-Related - virology; Male; Middle Aged; Risk Factors; Viral Load; Young Adult; EBV; HIV; biomarker; prognosis; lymphoma
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1093/cid/ciy542

Abstract Background Epstein-Barr virus (EBV) has been implicated in lymphomagenesis and can be found infecting tumor cells and in plasma at lymphoma diagnosis, especially in human immunodeficiency virus (HIV)-infected patients. Our aim was to evaluate the usefulness of plasma EBV load as biomarker and prognostic factor in HIV-positive patients with lymphomas. Methods EBV loads were measured by polymerase chain reaction in plasma samples of 81 HIV-positive patients’ lymphomas at different moments: within 1 year before lymphoma diagnosis, at diagnosis, and at complete response (CR). Control samples included HIV-negative patients with lymphomas and HIV-positive patients without neoplasia or opportunistic infections. Results HIV-positive patients with lymphomas had more frequently-detectable EBV load at lymphoma diagnosis (53%) than either HIV-negative patients with the same lymphoma type (16%; P < .001) or HIV-positive individuals without neoplasia or opportunistic infection (1.2%; P < .001). HIV-positive lymphoma patients with detectable EBV load in plasma at lymphoma diagnosis had statistically significant decrease of EBV load at CR. High EBV load (>5000 copies/mL) at lymphoma diagnosis was an independent negative prognostic factor for overall survival and progression-free survival in HIV-positive patients with lymphomas. Detectable plasma EBV loads identified HIV-positive subjects that would eventually develop lymphoma (area under the curve, 82%; 95% CI: 0.67–0.96). Conclusions Plasma EBV load can be used as a biomarker and as a prognostic factor in HIV-positive patients with lymphomas. The presence of the EBV load in the plasma of an HIV-positive patient can be an early predictor of lymphoma development. Epstein-Barr virus (EBV) in plasma is associated with lymphomas in patients with human immunodeficiency virus (HIV): it can be a lymphoma biomarker and predict lymphoma development. High EBV loads have negative prognostic impacts on HIV patients with lymphomas.