Suligoi Barbara, Dorrucci Maria, Uccella Ilaria, Andreoni Massimo, Rezza Giovanni
Reparto AIDS e MST, Istituto Superiore di Sanità, Rome, Italy.
J Med Virol. 2003 Feb;69(2):182-7. doi: 10.1002/jmv.10281.
The effects of herpesviruses infection on the progression of HIV disease remain controversial, with some studies showing accelerated progression and others showing no effect. Furthermore, the effect of concurrent infection with more than one herpesvirus on the progression of HIV disease has never been investigated. To this end, the rates of progression of HIV disease were determined after stratifying for the presence of up to five different herpesvirus infections. The study population consisted of 359 HIV-infected persons for whom the date of seroconversion was estimated (part of the Italian Seroconversion Study). One serum sample from each participant was tested for antibodies to five herpesviruses: HSV-2, CMV, HHV-6, HHV-7, and HHV-8. Univariate analysis showed that HSV-2 and HHV-8 were significantly associated with progression to AIDS, yet when adjusting for age at HIV seroconversion and for the presence of the other herpesvirus infections, only HHV-8 infection showed a significant association. The age-adjusted risk of progression to AIDS with Kaposi's sarcoma increased with the number of herpesvirus infections and was significant in individuals with four infections. The risk of progression to AIDS without Kaposi's sarcoma also increased with the number of infections, although not significantly. Similar results were found when considering CD4+ cell count <200 x 10(6) cells/L as the endpoint. Concurrent infection with more than one herpesvirus does not appear to have a significant effect on the course of HIV disease, except for the known association between HHV-8 and Kaposi's sarcoma. However, even after excluding Kaposi's sarcoma from the AIDS-defining endpoints, a slightly increased risk for participants with four herpesvirus infections remained.
疱疹病毒感染对HIV疾病进展的影响仍存在争议，一些研究表明疾病进展加速，而另一些研究则表明没有影响。此外，同时感染多种疱疹病毒对HIV疾病进展的影响从未被研究过。为此，在对多达五种不同疱疹病毒感染的存在进行分层后，确定了HIV疾病的进展率。研究人群包括359名估计了血清转化日期的HIV感染者（意大利血清转化研究的一部分）。对每位参与者的一份血清样本检测了针对五种疱疹病毒的抗体：单纯疱疹病毒2型（HSV-2）、巨细胞病毒（CMV）、人类疱疹病毒6型（HHV-6）、人类疱疹病毒7型（HHV-7）和人类疱疹病毒8型（HHV-8）。单因素分析表明，HSV-2和HHV-8与进展为艾滋病显著相关，但在调整HIV血清转化时的年龄和其他疱疹病毒感染的存在情况后，只有HHV-8感染显示出显著相关性。随着疱疹病毒感染数量的增加，伴有卡波西肉瘤进展为艾滋病的年龄调整风险增加，在有四种感染的个体中具有显著性。不伴有卡波西肉瘤进展为艾滋病的风险也随着感染数量的增加而增加，尽管不显著。当将CD4+细胞计数<200×10⁶个细胞/L作为终点时，发现了类似的结果。除了已知的HHV-8与卡波西肉瘤之间的关联外，同时感染多种疱疹病毒似乎对HIV疾病的病程没有显著影响。然而，即使在将卡波西肉瘤从艾滋病定义终点中排除后，有四种疱疹病毒感染的参与者的风险仍略有增加。
