title: Epstein-Barr virus load in children infected with human immunodeficiency virus type 1 in Uganda.
abstract: BACKGROUND
  Epstein-Barr Virus (EBV) is involved in a wide range of malignancies, particularly in immunocompromised 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.
authors.affiliation: Unit of Viral Oncology, Section of Oncology and Immunology, Department of Surgery, Oncology, and Gastroenterology AIDS Reference Center.
authors.forename: Maria Raffaella
authors.initials: MR
authors.lastname: Petrara
authors.affiliation: Department of Pediatrics, University of Padua Tukula Fenna Project.
authors.forename: Martina
authors.initials: M
authors.lastname: Penazzato
authors.affiliation: Tukula Fenna Project.
authors.forename: William
authors.initials: W
authors.lastname: Massavon
authors.affiliation: Home Care Department, St. Raphael of St. Francis Hospital at Nsambya, Kampala, Uganda.
authors.forename: Sandra
authors.initials: S
authors.lastname: Nabachwa
authors.affiliation: Home Care Department, St. Raphael of St. Francis Hospital at Nsambya, Kampala, Uganda.
authors.forename: Maria
authors.initials: M
authors.lastname: Nannyonga
authors.affiliation: Hospital of Cles, Cles, Italy Tukula Fenna Project.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mazza
authors.affiliation: Unit of Viral Oncology, Section of Oncology and Immunology, Department of Surgery, Oncology, and Gastroenterology AIDS Reference Center.
authors.forename: Ketty
authors.initials: K
authors.lastname: Gianesin
authors.affiliation: Istituto Oncologico Veneto-IRCCS.
authors.forename: Paola
authors.initials: P
authors.lastname: Del Bianco
authors.affiliation: Statistical and Epidemiological Consultant, PENTA ONLUS Foundation, Padua.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lundin
authors.affiliation: Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Colin
authors.initials: C
authors.lastname: Sumpter
authors.affiliation: Istituto Oncologico Veneto-IRCCS.
authors.forename: Marisa
authors.initials: M
authors.lastname: Zanchetta
authors.affiliation: Department of Pediatrics, University of Padua Tukula Fenna Project.
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.affiliation: Unit of Viral Oncology, Section of Oncology and Immunology, Department of Surgery, Oncology, and Gastroenterology AIDS Reference Center Istituto Oncologico Veneto-IRCCS.
authors.forename: Anita
authors.initials: A
authors.lastname: De Rossi
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000302:isolation & purification; D020031:Epstein-Barr Virus Infections / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015497:HIV-1 / Q000302:isolation & purification*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral
keywords: African children; EBV; HIV-1; antiretroviral therapy; immune activation