Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women.

Department of Global Health
The Journal of Infectious Diseases (Impact Factor: 5.85). 03/2013; DOI: 10.1093/infdis/jit093
Source: PubMed

ABSTRACT Background. 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-1 and EBV viral load 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 0.78 (95%CI:0.67-0.88) in HIV-infected and 0.49 (95%CI:0.35-0.65) in HIV-uninfected infants (p<0.0001). At 2 years, probability of EBV infection was 0.96 (95%CI:0.89-0.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 versus 2.1&emsp14;log10copies/ml; p<0.0001). 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-1 infected infants, and 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. Primary EBV may manifest as severe disease in HIV-infected infants.

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