Stevens Servi J C, Blank Brian S N, Smits Paul H M, Meenhorst Pieter L, Middeldorp Jaap M
Department of Pathology, University Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
AIDS. 2002 May 3;16(7):993-1001. doi: 10.1097/00002030-200205030-00005.
To study Epstein-Barr virus (EBV) DNA loads in peripheral blood of HIV carriers to determine base-line values and diagnostic relevance of viral load in relation to quantitative serology; to compare EBV presence in parallel plasma and unfractionated whole blood samples; and to correlate EBV DNA load to HIV, CD4 T-cell counts and HAART.
One-hundred and nine random patients receiving highly active antiretroviral therapy (HAART) during 1999 and 99 patients on anti-HIV monotherapy during 1993-1996 were included.
EBV DNA load was determined by quantitative competitive PCR. EBV serology was determined by immunoblot profile and quantitative enzyme-linked immunosorbent assay for responses against VCA-p18 and EBNA-1.
Twenty-two out of 109 patients receiving HAART and 28 out of 99 of patients on anti-HIV monotherapy showed elevated EBV DNA loads in whole blood (> 2000 copies/ml), without elevated loads in parallel plasma. EBV DNA load distribution did not differ between the two groups (P = 0.78) and did not correlate with HIV or CD4 T-cell count. In three patients with high EBV DNA loads EBV RNA was virtually absent. Patients with high EBV DNA loads (3610-89 400 copies/ml) had higher anti-VCA-p18 IgG levels than patients with undetectable EBV DNA (P < 0.0001) but lower anti-EBNA-1 IgG levels (P = 0.005).
Absolute values of EBV DNA load may have poor diagnostic value for defining HIV patients at risk for developing EBV-associated disease. Elevated EBV DNA loads are cell-associated and are not influenced by HAART. Increased anti-p18-VCA and decreased anti-EBNA-1 IgG levels in patients with high EBV loads indicate impaired latency control and increased lytic replication suggesting disturbed overall immunosurveillance against EBV.
研究人类免疫缺陷病毒（HIV）携带者外周血中EB病毒（EBV）DNA载量，以确定病毒载量的基线值及其与定量血清学诊断的相关性；比较平行血浆样本和未分离全血样本中EBV的存在情况；并将EBV DNA载量与HIV、CD4 T细胞计数及高效抗逆转录病毒治疗（HAART）进行关联分析。
纳入1999年接受高效抗逆转录病毒治疗（HAART）的109例随机患者以及1993 - 1996年接受抗HIV单一疗法的99例患者。
采用定量竞争聚合酶链反应（PCR）测定EBV DNA载量。通过免疫印迹分析和针对VCA-p18及EBNA-1反应的定量酶联免疫吸附测定法检测EBV血清学。
109例接受HAART的患者中有22例以及99例接受抗HIV单一疗法的患者中有28例全血中的EBV DNA载量升高（>2000拷贝/毫升），而平行血浆样本中的载量未升高。两组之间EBV DNA载量分布无差异（P = 0.78），且与HIV或CD4 T细胞计数无关。在3例EBV DNA载量高的患者中几乎检测不到EBV RNA。EBV DNA载量高的患者（3610 - 89400拷贝/毫升）比EBV DNA检测不到的患者具有更高的抗VCA-p18 IgG水平（P < 0.0001），但抗EBNA-1 IgG水平较低（P = 0.005）。
EBV DNA载量的绝对值对于确定有发生EBV相关疾病风险的HIV患者可能诊断价值不大。升高的EBV DNA载量与细胞相关，不受HAART影响。EBV载量高的患者中抗p18-VCA增加及抗EBNA-1 IgG水平降低表明潜伏控制受损且裂解复制增加，提示针对EBV的整体免疫监视受到干扰。
