Abstract
Background: The aim of the present study was to evaluate the immunological profile of adult HIV-1+ patients coinfected with primary Epstein–Barr virus (EBV) infection who were free of antiretroviral drugs and inhabitants of the Brazilian Amazon region. Materials and methods: Primary EBV infection was screened by the semiquantitative detection of IgM and IgG anti-VCA. Genotypes were determined by conventional PCR. EBV and HIV viral load (VL) were quantified by real-time PCR. Cytokine dosage and cell quantification were performed by cytometry. Results: Only HIV-1+ individuals had primary EBV infection (7.12%). The EBV-1 genotype was the most prevalent (47.37%). The VL of HIV-1 was lower in the HIV/EBV-2 group. CD4+ T lymphocytes were inversely proportional to the VL of EBV in HIV/EBV-1/2 multi-infected patients. The HIV/EBV-2 group had the lowest cytokine levels, especially IFN-γ and IL-4. Different correlations were proposed for each coinfection. The late search for specific care related to HIV infection directly affected the cytokine profile and the number of CD8+ T lymphocytes. Symptoms were associated with the increase in VL of both viruses and cytokine profile. Conclusions: Different immunological profiles were associated with EBV genotypes in primary infection, with EBV-2 being more frequent in patients with low levels of HIV viral load. With late infection monitoring and consequent delay in the initiation of HAART, clinical changes and effects on the maintenance of the immune response were observed.
Highlights
Epstein–Barr virus (EBV) is considered one of the risk factors for morbidity in people living with HIV (PLHIV) because it is a precursor of neoplasms in this group [1,2,3]
The aim of this study was to evaluate the immunological profile of adult PLHIV who were free of antiretroviral drugs (HAART) and presented with primary coinfection with different EBV genotypes; we sought to associate immunological markers with the viral dynamics of HIV/primary EBV coinfection and the clinical aspects of the patients to reveal the possible impacts of the late attendance of the patient
Of the 333 participants evaluated between January 2018 and December 2019, only 19 were positive for primary EBV infection, all of them infected with HIV-1; we obtained a prevalence of 7.09% of coinfected individuals (Table 1), with the majority living in the metropolitan mesoregion of Belém city (98.20%)
Summary
Epstein–Barr virus (EBV) is considered one of the risk factors for morbidity in people living with HIV (PLHIV) because it is a precursor of neoplasms in this group [1,2,3]. EBV-1 is more prevalent in patients with fewer helper T lymphocytes and a high HIV viral load, while EBV-2 predominates in more responsive immune profiles comprising numerous helper T lymphocytes and a low HIV viral load [9,10,11]; it is not clear whether this trend is a pattern observed only in primary EBV infection In this context, the aim of this study was to evaluate the immunological profile of adult PLHIV who were free of antiretroviral drugs (HAART) and presented with primary coinfection with different EBV genotypes; we sought to associate immunological markers with the viral dynamics of HIV/primary EBV coinfection and the clinical aspects of the patients to reveal the possible impacts of the late attendance of the patient.
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