title: Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)-associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy.
  
  
  METHODS
  To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA-negative infants. Monthly clinical examinations were performed by pediatricians.
  
  
  RESULTS
  The probability of EBV infection by 1 year of age was .78 (95% CI, .67-.88) in HIV-infected and .49 (95% CI, .35-.65) in HIV-uninfected infants (P < .0001). At 2 years, probability of EBV infection was .96 (95% CI, .89-.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P < .0001). The majority of HIV-infected infants had detectable EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants.
  
  
  CONCLUSIONS
  EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection.
authors.affiliation: Department of Global Health, Division of Allergy and Infectious Diseases, University of Washington Seattle, WA 98104 USA. jslyker@u.washington.edu
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Slyker
authors.forename: Corey
authors.initials: C
authors.lastname: Casper
authors.forename: Kenneth
authors.initials: K
authors.lastname: Tapia
authors.forename: Barbra
authors.initials: B
authors.lastname: Richardson
authors.forename: Lisa
authors.initials: L
authors.lastname: Bunts
authors.forename: Meei-Li
authors.initials: ML
authors.lastname: Huang
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Maleche-Obimbo
authors.forename: Ruth
authors.initials: R
authors.lastname: Nduati
authors.forename: Grace
authors.initials: G
authors.lastname: John-Stewart
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000635:transmission / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D007630:Kenya / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D019562:Viral Load; D014766:Viremia; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral
keywords: EBV; HIV; herpesviruses; pediatric; primary infection