Dynamics of Epstein-Barr Virus DNA concentrations in whole blood of HIV-1-infected patients during primary HIV-1 infection

Introduction: Epstein-Barr virus (EBV) viraemia is associated with nasopharyngeal carcinoma and lymphoproliferative diseases. In HIV-1 infection, persistent EBV viraemia is a common phenomenon. The underlying mechanism of these high EBV DNA loads has not been clarified. We studied EBV viraemia during primary HIV-1 infection (PHI) to explore the mechanism of EBV viraemia in HIV-1 infection. Methods: Patients with PHI, participating in Primo-SHM study, a clinical trial with three study arms: no treatment, 24 weeks of combination antiretroviral therapy (cART) and 60 weeks of cART, were sampled longitudinally during PHI and 24 and 48 weeks thereafter. EBV DNA was assayed by PCR on stored samples of lysed whole blood. Results: 39 patients were tested, in 22 of whom EBV DNA was detected at one or more time points. All patients tested positive for anti-VCA and anti-EBNA antibodies, most patients that had EBV viraemia did not receive cART or interrupted cART. The prevalence of EBV viraemia at baseline was 29%, 18% and 33% for the untreated, 24 weeks cART and continuous cART groups. At week 48, these percentages were 38, 64 and 17 respectively (p < 0.05). Individual concentrations of EBV DNA for the three groups are shown in figure 1. Conclusion: Intermittent EBV viraemia is highly prevalent in patients with PHI. Assuming that patients with very early HIV-1 infection are still immunocompetent, this indicates that EBV viraemia is not caused by immunodeficiency. Antiretroviral therapy started during PHI but not later during chronic HIV infection might reduce the prevalence of EBV viraemia in HIV-1 infection. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Steingrover R et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18406 http://www.jiasociety.org/index.php/jias/article/view/18406 | http://dx.doi.org/10.7448/IAS.15.6.18406