title: Blood Epstein-Barr virus DNA load and risk of progression to AIDS-related systemic B lymphoma.
abstract: BACKGROUND
  AIDS-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the combined antiretroviral therapy (cART) era. Although most ARLs are associated with the Epstein-Barr virus (EBV), whether patients with high EBV burden are more at risk of developing ARL is unknown. This study investigated the relationship between high blood EBV DNA loads and subsequent progression to ARL.
  
  
  METHODS
  We identified 43 cases of ARL diagnosed between 1988 and 2007 within two cohorts (ANRS SEROCO/HEMOCO and PRIMO) and for which stored serum and peripheral blood mononuclear cell (PBMC) samples were available within 3 years before ARL diagnosis. For each case, two controls matched for the cohort and CD4 cell count in the year of ARL diagnosis were selected. EBV DNA was measured in PBMCs and serum samples with a commercial kit.
  
  
  RESULTS
  High levels of EBV DNA in PBMCs collected a median of 10 months before diagnosis were associated with an increased risk of developing systemic B lymphoma (adjusted odds ratio 2.47; 95% confidence interval 1.15; 5.32 for each 1 log copies/10(6) PBMC increase in EBV load) but not with primary brain lymphoma.
  
  
  CONCLUSIONS
  In this study, HIV-infected patients with undetectable EBV DNA in PBMCs did not develop ARL in the following 3 years, while high levels of EBV DNA in PBMCs predicted subsequent progression to systemic B lymphoma. Clinicians should be aware of the increased risk of developing systemic B lymphoma in HIV-infected patients with a high blood EBV DNA load.
authors.affiliation: Virology Laboratory, Necker-Enfants-Malades Hospital, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. marianne.leruez@nck.aphp.fr
authors.forename: M
authors.initials: M
authors.lastname: Leruez-Ville
authors.forename: R
authors.initials: R
authors.lastname: Seng
authors.forename: P
authors.initials: P
authors.lastname: Morand
authors.forename: F
authors.initials: F
authors.lastname: Boufassa
authors.forename: F
authors.initials: F
authors.lastname: Boue
authors.forename: C
authors.initials: C
authors.lastname: Deveau
authors.forename: C
authors.initials: C
authors.lastname: Rouzioux
authors.forename: C
authors.initials: C
authors.lastname: Goujard
authors.forename: J M
authors.initials: JM
authors.lastname: Seigneurin
authors.forename: L
authors.initials: L
authors.lastname: Meyer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000150:complications / Q000821:virology*; D016393:Lymphoma, B-Cell / Q000821:virology*; D008297:Male; D016017:Odds Ratio; D019562:Viral Load
chemical_list: D004279:DNA, Viral