Abstract
Objective : Cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV-6) are all herpes group DNA viruses, most of which are known to be acquired in early childhood and remain as latent infections through out life. It is widely known that, in the state of immunodeficiency that results from human immunodeficiency virus (HIV) infection, CMV causes opportunistic infections such as retinitis and pneumonia. However, there have not been many reports on the kinetics of EBV and HHV- 6, which also have latent infectivity. In this study, we measured and analyzed the levels of DNA of these three viruses in HIV-positive subjects.
Materials : Subjects comprised 51 untreated HIV-positive patients who visited our outpatient clinic between April 2001 and October 2005, excluding AIDS patients who had already developed opportunistic infections.
Methods : Using real-time PCR, we quantified the DNA of CMV, EBV, and HHV-6 in their peripheral venous leucocytes, and compared the results with those in healthy controls.
Measurement and Results : HIV-positive patients had a significantly higher rate of EBV positivity than healthy controls (64.7% vs. 9.8%, respectively : P<0.0001), but there was no correlation between EBV positivity and the number of CD4 cells. The rate of CMV positivity tended to be higher than in healthy controls (9.8% vs.0%, respectively : P =0.0564), and the number of CD4 cells in CMV-positive subjects was significantly lower than in controls. HHV-6 was detected in only one HIV-positive patient, and it was not detected in HIV-negative patients.
Conclusions : HIV-positive subjects who exhibited low CD4 cell counts had high rates of CMV infection, indicating that the activation of CMV may lead to such symptoms as pancytopenia, weight loss and general fatigue, even in patients who do not have obvious opportunistic infections. The rate of EBV positivity was significantly higher in HIV-positive patients than in controls, but was not correlated with the number of CD4-positive cells, suggesting that factors other than a decline in the CD4-positive cell count are involved in the process of EBV activation. Moreover, there was no significant difference in the HHV-6 positivity rate between HIV-positive subjects and healthy controls.
