High titers of Epstein-Barr virus antibodies in adult patients with lymphocytic interstitial pneumonitis associated with AIDS

Abstract

Lymphocytic interstitial pneumonitis (LIP) was classically described by Carrington and Leibow in 1966 in non-AIDS patients (1). This pathological description of diffuse lymphocytic infiltration of the interstitium was later associated with various autoimmune disorders such as Sjogren's syndrome, thyroiditis and others (2). Since the beginning of the AIDS epidemic several reports described the common finding of LIP in children infected with human immume deficiency virus (HIV) (3). Less commonly, LIP was reported in adults, mostly Haitians, with AIDS or AIDS-related complex (4--6). While the pathological and radiological manifestations are well described, little is known about the pathogenesis of this disorder. There is some evidence in children with AIDS that Epstein-Barr virus (EBV) is associated with LIP. Feckler and associates (7) reported the detection of EBV-DNA genome in saliva and lung tissue of a child with LIP and Adinman and colleagues (8) reported similar findings in eight additional AIDS-children with LIP. In order to explore the possible etiologic role of EBV in HIV-seropositive adults with LIP we measured the EBV serology in the peripheral blood of five patients with LIP and compared them to 19 HIV-positive patients without LIP.