Epstein-Barr Virus Load in Children Infected With Human Immunodeficiency Virus Type 1 in Uganda

• Published in: The Journal of infectious diseases Vol. 210; no. 3; pp. 392 - 399
• Main Authors: Petrara, Maria Raffaella, Penazzato, Martina, Massavon, William, Nabachwa, Sandra, Nannyonga, Maria, Mazza, Antonio, Gianesin, Ketty, Del Bianco, Paola, Lundin, Rebecca, Sumpter, Colin, Zanchetta, Marisa, Giaquinto, Carlo, De Rossi, Anita
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.08.2014
• Subjects: Adolescent; Anti-HIV Agents - therapeutic use; Biological and medical sciences; Child; Child, Preschool; DNA, Viral - isolation & purification; Epstein-Barr virus; Epstein-Barr Virus Infections - virology; Female; Fundamental and applied biological sciences. Psychology; Herpesvirus 4, Human - isolation & purification; HIV Infections - blood; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV-1 - isolation & purification; HIV/AIDS; Human immunodeficiency virus 1; Humans; Infant; Infectious diseases; Male; Medical sciences; Microbiology; Miscellaneous; Viral Load; Virology; Uganda; East Africa; Sub-Saharan Africa; Africa; Gammaherpesvirinae; Human; HIV-1 virus; Herpesviridae; Tropical zone; Retroviridae; Epstein Barr virus; Lentivirus; Virus; Infection; Equatorial zone; Human immunodeficiency virus; Child; HIV-1; EBV; African children; antiretroviral therapy; immune activation
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiu099

Background. Epstein-Barr Virus (EBV) is involved in a wide range of malignancies, particularly in immuno-compromised subjects. In Africa, EBV primary infection occurs during early childhood, but little is known about the EBV load in Human Immunodeficiency Virus type 1 (HIV-1)-infected children. Methods. Blood samples from 213 HIV-1-infected children, 140 of whom were receiving antiretroviral therapy (ART), were collected at the Nsambya Hospital in Kampala, Uganda, and obtained for dried blood spot analysis. Nucleic acids were extracted and analyzed for quantification of EBV types 1 and 2; 16S ribosomal DNA (rDNA), a marker of microbial translocation; and HIV-1 RNA. Results. Ninety-two of 140 children (66%) receiving ART and 57 of 73 ART-naive children (78%) had detectable EBV DNA levels. Coinfection with both EBV types was less frequent in ART-treated children than in ART-naive children (odds ratio, 0.54 [95% confidence interval {CI}, .30-.98]; P = .042). Mean EBV DNA levels (±standard deviation) were lower in the former (3.99 ± 0.59 vs 4.22 ± 0.54 log₁₀ copies/mL; P = .006) and tended to be inversely associated with ART duration. EBV DNA levels were higher in children with an HIV-1 RNA load of > 3 log₁₀ copies/mL of blood (regression coefficient, 0.32 [95%CI, .05-.59]; P = .020) and correlated with circulating 16S rDNA levels (rs = 0.25 [95% CI, .02-.46]; P = .031). Conclusions. These findings suggest that ART, by limiting HIV-1 replication, microbial translocation, and related immune activation, prevents superinfection with both EBV types and keeps EBV viremia down, thus potentially reducing the risk of EBV-associated lymphomas.