Unknown

Dataset Information

0

Presence of asymptomatic cytomegalovirus and Epstein--Barr virus DNA in blood of persons with HIV starting antiretroviral therapy is associated with non-AIDS clinical events.


ABSTRACT:

Background

Even with antiretroviral therapy (ART), persons with HIV (PWH) experience increased morbidity and mortality. Cytomegalovirus (CMV) and Epstein--Barr virus (EBV) co-infections likely exacerbate inflammatory-related diseases.

Objective

To determine if presence of detectable CMV or EBV DNA in peripheral blood mononuclear cells (PBMC) is associated with non-AIDS events among PWH receiving modern ART.

Design

We performed a case--control study of PWH starting ART and HIV-suppressed at year 1 and thereafter, 140 cases who experienced non-AIDS events and 305 matched controls. Events included myocardial infarction, stroke, malignancy, serious bacterial infection or death.

Methods

Blood samples were studied pre-ART, 1-year post-ART and pre-event. Controls had an event-free follow-up equal or greater than cases. CMV and EBV DNA levels were measured in PBMC. Conditional logistic regression analysis assessed associations and adjusted for relevant covariates; Spearman's correlations compared CMV and EBV DNA levels with other biomarkers.

Results

CMV DNA was detected in PBMC of 25% of participants, EBV DNA was detected in more than 90%. Higher EBV DNA levels were associated with increased risk of events at all time points (odds ratio (OR) per one IQR = 1.5-1.7, all P < 0.009). At year 1, detectable CMV DNA was associated with increased risk of events in most adjusted models (OR = 1.4-1.8, P values ranging 0.03-0.17). Higher levels of CMV and EBV DNA correlated with multiple inflammatory markers and lower CD4/CD8 ratio.

Conclusion

In PWH starting ART, detection of CMV and EBV DNA in PBMC was associated with development of non-AIDS events. Clinical trials will be needed to understand causal mechanisms and ways to interrupt them.

SUBMITTER: Gianella S 

PROVIDER: S-EPMC7239326 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

altmetric image

Publications

Presence of asymptomatic cytomegalovirus and Epstein--Barr virus DNA in blood of persons with HIV starting antiretroviral therapy is associated with non-AIDS clinical events.

Gianella Sara S   Moser Carlee C   Vitomirov Andrej A   McKhann Ashley A   Layman Laura L   Scott Brianna B   Caballero Gemma G   Lada Steven S   Bosch Ronald J RJ   Hoenigl Martin M   Lurain Nell N   Landay Alan A   Lederman Michael M MM   Hunt Peter W PW   Smith Davey D  

AIDS (London, England) 20200501 6


<h4>Background</h4>Even with antiretroviral therapy (ART), persons with HIV (PWH) experience increased morbidity and mortality. Cytomegalovirus (CMV) and Epstein--Barr virus (EBV) co-infections likely exacerbate inflammatory-related diseases.<h4>Objective</h4>To determine if presence of detectable CMV or EBV DNA in peripheral blood mononuclear cells (PBMC) is associated with non-AIDS events among PWH receiving modern ART.<h4>Design</h4>We performed a case--control study of PWH starting ART and H  ...[more]

Similar Datasets

| S-EPMC5810321 | biostudies-literature
| S-EPMC4376400 | biostudies-literature
| S-EPMC4344231 | biostudies-literature
| S-EPMC5649756 | biostudies-literature
| S-EPMC3768663 | biostudies-literature
| S-EPMC8205610 | biostudies-literature
| S-EPMC8176631 | biostudies-literature
| S-EPMC8631144 | biostudies-literature
| S-EPMC8938541 | biostudies-literature
| S-EPMC6935903 | biostudies-literature