title: Significance of Epstein-Barr virus (HHV-4) and CMV (HHV-5) infection among subtype-C human immunodeficiency virus-infected individuals.
abstract: OBJECTIVE
  Opportunistic viral infections are one of the major causes of morbidity and mortality in HIV infection and their molecular detection in the whole blood could be a useful diagnostic tool.
  
  
  OBJECTIVE
  The frequency of opportunistic DNA virus infections among HIV-1-infected individuals using multiplex real-time PCR assays was studied.
  
  
  METHODS
  The subjects were in two groups; group 1: Having CD4 counts<100 cells/µl (n=118) and the group 2: counts>350 cells/µl (n=173). Individuals were classified by WHO clinical staging system. Samples from 70 healthy individuals were tested as controls. In-house qualitative multiplex real-time PCR was standardised and whole blood samples from 291 were tested, followed by quantitative real-time PCR for positives. In a proportion of samples genotypes of Epstein-Barr virus (EBV) and CMV were determined.
  
  
  RESULTS
  The two major viral infections observed were EBV and CMV. The univariate analysis of CMV load showed significant association with cryptococcal meningitis, oral hairy leukoplakia (OHL), CMV retinitis, CD4 counts and WHO staging (P<0.05) while the multivariate analysis showed an association with OHL (P=0.02) and WHO staging (P=0.05). Univariate analysis showed an association of EBV load with CD4 counts and WHO staging (P<0.05) and multivariate analysis had association only with CD4 counts. The CMV load was significantly associated with elevated SGPT and SGOT level (P<0.05) while the EBV had only with SGOT.
  
  
  CONCLUSIONS
  This study showed an association of EBV and CMV load with CD4+ T cell counts, WHO staging and elevated liver enzymes. These viral infections can accelerate HIV disease and multiplex real-time PCR can be used for the early detection. Genotype 1 and 2 of EBV and genotype gB1 and gB2 of CMV were the prevalent in the HIV-1 subtype C-infected south Indians.
authors.forename: J
authors.initials: J
authors.lastname: Sachithanandham
authors.affiliation: Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: R
authors.initials: R
authors.lastname: Kannangai
authors.forename: S A
authors.initials: SA
authors.lastname: Pulimood
authors.forename: A
authors.initials: A
authors.lastname: Desai
authors.forename: A M
authors.initials: AM
authors.lastname: Abraham
authors.forename: O C
authors.initials: OC
authors.lastname: Abraham
authors.forename: V
authors.initials: V
authors.lastname: Ravi
authors.forename: P
authors.initials: P
authors.lastname: Samuel
authors.forename: G
authors.initials: G
authors.lastname: Sridharan
mesh_terms: D001769:Blood / Q000821:virology*; D018791:CD4 Lymphocyte Count; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology* / Q000821:virology; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1 / Q000302:isolation & purification; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D060885:Multiplex Polymerase Chain Reaction; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D019562:Viral Load