Evaluation of Epstein-Barr Virus Salivary Shedding in HIV/AIDS Patients and HAART Use: A Retrospective Cohort Study
Little data is available on the evaluation of the occurrence rates of Epstein-Barr virus (EBV) in saliva and relationship with highly active antiretroviral therapy (HAART) use in HIV/AIDS patients in China. We conducted a retrospective cohort study of EBV serological tests for HIV/AIDS patients who were treated in the hospitals for infectious diseases in Wuxi and Shanghai, China from May 2016 to April 2017. The EBV-seropositive samples were identified by ELISA. EBV-specific primers and probes were used for the quantitative detection of viral DNA from saliva via quantitative real-time polymerase chain reaction. CD4 cell counts of the HIV/AIDS patients were detected by a flow cytometry. A total of 372 HIV/AIDS patients were ultimately selected and categorized for this retrospective cohort study. For EBV IgG and IgM, the HIV/AIDS HAART use (H) and non-HAART use (NH) groups had significantly higher seropositive rates than the HIV-negative control group. The HIV/AIDS (NH) group had the highest seropositive rate (IgG, 94.27%; IgM, 68.98%) and the highest incidence of EBV reactivation or infection. For salivary EBV DNA-positive rates and quantities, the HIV/AIDS (H) (73.69%) and the HIV/AIDS (NH) (100%) groups showed significantly higher values than the HIV-negative control group (35.79%, > twofold). Further, the salivary EBV DNA-negative population had significantly higher CD4 cell counts than the EBV DNA-positive population in the HIV/AIDS (H) group and the HIV/AIDS (NH) groups. Thus, HAART use is beneficial in decreasing the EBV salivary shedding in HIV/AIDS patients and indirectly decreases EBV transmission risk.
KeywordsEpstein-Barr virus (EBV) Human immunodeficiency virus (HIV) Saliva HIV/AIDS Highly active antiretroviral therapy (HAART)
We thank Yanping Guo and Xiaojuan Yang from the Department of Medical Instruments of Wuxi Fifth People’s Hospital Affiliated to Jiangnan University for the purchase of reagents. This work was supported by the Grant of Wuxi Technology Bureau Scientific and Technology Project (CSE31N1607), the Wuxi Key Medical Talents Program (ZDRC024), Shanghai Pujiang Program (15PJ1407300), the Wuxi Medical Development Discipline Program (FZXK006, MS201702), the Significant Program from Wuxi Health and Family Planning Commission (z201603), the National High Technology Research and Development Program of China (2014AA021403), the National Natural Science Foundation of China (81571977, 81701550) and the Project from Shanghai Municipal Commission of Health and Family Planning (15GWZK0103).
HZL, LHH and YY conceived the study. YY, YR, RFC, YJJ, JYY, JW and JH carried out the experiments and formal analysis. YR, RFC, JYS, JYY, YWQ, LYH and HP carried out the investigation. YY and YR wrote the paper. HZL and LHH checked and finalized the manuscript. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Animal and Human Rights Statement
The study project was submitted to and approved by the Fifth People’s Hospital of Wuxi, Affiliated to Jiangnan University Ethics Committee and the Shanghai Public Health Clinical Center Ethics Committee. The Ethics Committee authorized this study, which was performed with written informed-consent files by patients and was anonymous.
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