Epstein-Barr Virus load in children infected with Human Immunodeficiency Virus type 1 in Uganda

Maria Raffaella Petrara, Martina Penazzato, William Massavon, Sandra Nabachwa, Maria Nannyonga, Antonio Mazza, Ketty Gianesin, Paola Del Bianco, Rebecca Lundin, Colin Sumpter, Marisa Zanchetta, Carlo Giaquinto, Anita De Rossi

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)392-399
Number of pages8
JournalJournal of Infectious Diseases
Issue number3
Publication statusPublished - Aug 1 2014


  • African children
  • Antiretroviral therapy
  • EBV
  • HIV-1
  • Immune activation

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy


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