EPSTEIN-BARR-VIRUS INFECTION IN HIV-POSITIVE PATIENTS

The relationship between Epstein-Barr virus (EBV) viral load in periph eral blood and HIV infection was determined in 103 HIV-infected patien ts. Epstein-Barr virus was detected by polymerase chain reaction in 75 % of the patients, 21 % of whom had the more uncommon EBV subtype 2. The highest levels of EBV were found in patients with 100-400 CD4+ cel ls/mm3 and not in those with more profound immunosuppression. An assoc iation was identified between EBV load and HIV proviral levels (p < 0. 001), an IgM response to EBV early antigens (p less-than-or-equal-to 0 .01) and p24 antigenemia (p < 0.01 in patients with > 100 CD4+ cells), but not with other clinical or laboratory parameters. Combinations of different EBV and HIV parameters identified a subgroup of patients wi th a 2.2- to 4.8-fold risk of greater-than-or-equal-to 35 % decline in CD4+ counts over six months. The association between EBV and HIV mark ers may reflect a significant pathogenic interaction between the two v iruses.