title: Epstein-Barr virus genome load is increased by therapeutic vaccination in HIV-l carriers, and further enhanced in patients with a history of symptomatic primary infection.
abstract: OBJECTIVE
  Epstein-Barr virus (EBV) infection is an established risk factor for B-cell lymphomas in Human Immunodeficiency virus (HIV)-1 infected patients. A disturbed EBV-host relationship is seen in patient groups with a high risk for EBV-associated lymphomas. We have analysed this relationship by measuring EBV-DNA in the blood of HIV-1 carriers.
  
  
  METHODS
  EBV-DNA load in B-cells was monitored by PCR in non- or insufficiently antiretroviral treated and rgp160-vaccinated HIV-patients.
  
  
  RESULTS
  Both asymptomatic HIV-infected and AIDS-patients showed a 25-40-fold increase in the number of B cell associated EBV-DNA copies compared to healthy controls. Patients included in a vaccine trial with recombinant HIV gp160 showed a 5-fold increase of EBV load compared to non-immunised patients and a 50-fold increase compared to healthy controls. There was no difference whether they received vaccine or "placebo". Vaccinated patients with a history of symptomatic primary HIV-1 infection (PHI) had a 280-fold increase in median EBV load compared to healthy controls, thus suggesting a synergistic effect between the vaccination and PHI, which hypothetically could affect lymphoma risk.
  
  
  CONCLUSIONS
  We recommend analysis of EBV-load and long term follow up of lymphoma risk in all therapeutic HIV-1 vaccination trials.
authors.affiliation: Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institute, Box 280, SE-171 77, Stockholm, Sweden. anna.friis@ki.se
authors.forename: Anna M C
authors.initials: AM
authors.lastname: Friis
authors.forename: Börje
authors.initials: B
authors.lastname: Akerlund
authors.forename: Katarina
authors.initials: K
authors.lastname: Gyllensten
authors.forename: Anna
authors.initials: A
authors.lastname: Aleman
authors.forename: Göran
authors.initials: G
authors.lastname: Bratt
authors.forename: Eric
authors.initials: E
authors.lastname: Sandström
authors.forename: Ingemar
authors.initials: I
authors.lastname: Ernberg
mesh_terms: D016915:AIDS Vaccines / Q000008:administration & dosage*; D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology / Q000821:virology; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D019562:Viral Load
chemical_list: D016915:AIDS Vaccines; D000276:Adjuvants, Immunologic; D004279:DNA, Viral; C053473:VaxSyn HIV-1 (gp160) vaccine