Abstract
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.
Highlights
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region
The epidemiological profiles of patients monoinfected with HIV-1 and coinfected with HIV/EBV were statistically similar; we grouped them for comparison with the noninfected group
We show that the risk of HIV/EBV-1/2 multiple infection was higher in patients with longer HIV-1 infection, which emphasizes our warning because coinfections are common in patients who start treatment late, have the highest associated risk rate, and are correlated with advanced clinical disease stages[117,118]
Summary
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. In. developing countries, primary EBV infection occurs in early childhood and is usually asymptomatic, reaching 97% seroprevalence in adulthood in heterogeneous populations, a value that is similar at the global s cale[10,11]. Developing countries, primary EBV infection occurs in early childhood and is usually asymptomatic, reaching 97% seroprevalence in adulthood in heterogeneous populations, a value that is similar at the global s cale[10,11] In these countries, there is an alert for seroprevalence in children and adolescents with low socioeconomic status[12] and for the predominance of infection in individuals with suspected coinfection with human immunodeficiency virus (HIV)-113. This factor becomes critical when the infection progresses to AIDS, in which severe immunosuppression results in clinical signs and symptoms related to malignant n eoplasms[18,19]
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