Clinicopathologic Comparison of Plasmablastic Lymphoma Patients According HIV-Status: Peruvian Experience

Background:Plasmablastic lymphoma (PBL) is an aggressive lymphoma associated mainly to HIV infection, although cases in immunocompetent patients are described as well. Objective:To describe the clinicopathologic features and determine the overall survival of lymphoma patients according human immunodeficiency virus (HIV) status in Peruvian patients. Methods:We reviewed the pathology databases of 2 cancer centers and a general hospital from Peru. Forty cases were documented between 2005 and 2020. Categorical variables were compared using Fisher's exact test. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Statistical analysis was based on SPSS Program version 23. All cases were reviewed by two pathologists. Results:32 patients (80%) were HIV-positive. The median age for the whole cohort was 40 years (range, 22-86). The median age for HIV-positive and HIV-negative PBL patients were 37 years (range 22-67 years) and 57 years (range 27-86 years), respectively. The proportion of patients ≥60 years was lower in HIV-positive than in HIV-negative patients (8% and 37%, respectively; p= 0.046). 80% of patients in the whole cohort were female, and 84% and 62% in the HIV-positive and HIV-negative group, respectively. Extra-oral primary sites were the most frequent primary sites in both groups (66% and 88%, respectively). There were no statistically significant differences in Ann Arbor stage, Ki-67 expression, LDH levels, IPI scores, albumin levels, and neutrophil/lymphocyte ratio between HIV-positive and HIV-negative patients. All cases showed large lymphoid cells, of plasmablastic morphology with expression of at least one plasma cell marker (CD138, CD38, MUM1), CD45 positivity, variable expression of EMA, CD79 and CD30 and absence of expression of CD20, CD3, CD68 and LMP1; the proliferative index Ki67 varied between 60 and 90%. A small proportion of patients (18%) did not receive chemotherapy because of poor performance status or a personal decision. DA-EPOCH regimen was used in 52% and 25% of HIV+ and HIV- patients, respectively and CHOP/CHOEP regimen in 48 % and 75%, respectively. The overall response rate was 68% and 57% in HIV+ and HIV- patients with complete response (CR) in 32% and 14%, respectively. In the HIV-positive group, 66% of patients were antiretroviral therapy (ART)-naïve. The median progression-free survival (PFS) was 38 months and 7 months for HIV+ and HIV- patients, and the 1-year PFS was 74% and 0%, respectively. The median overall survival (OS) was 43 months (range 0.2-86.5) in HIV-positive patients and 10 months (range 0.5-19.0 months) in HIV-negative patients and the 1-year OS were 59% y 38%, respectively (p=0.27). Conclusions: PBL is a rare lymphoma, specially, if not related to HIV infection. In this study, 60 years or older was the only variable that showed significant difference. In our cohort, HIV-positive patients had better prognosis than HIV-negative PBL patients. Disclosures No relevant conflicts of interest to declare.

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Clinicopathologic Comparison of Plasmablastic Lymphoma in HIV-Positive Versus HIV-Negative Patients: Single-Center Experience

Blood ◽

10.1182/blood.v128.22.1864.1864 ◽

2016 ◽

Vol 128 (22) ◽

pp. 1864-1864 ◽

Cited By ~ 1

Author(s):

Jule Vasquez ◽

Jorge Huamanchumo ◽

Shirley Quintana

Keyword(s):

Overall Survival ◽

Hiv Infection ◽

B Cell ◽

Conflicts Of Interest ◽

Plasmablastic Lymphoma ◽

Aggressive Lymphoma ◽

Cancer Center ◽

Hiv Positive ◽

Hiv Patients ◽

Hiv Negative

Abstract Background: Plasmablastic lymphoma (PBL) is an aggressive lymphoma associated mainly to HIV infection, although cases in immunocompetent patients are described as well. Objective: To describe the prevalence, the clinicopathologic features and determine the overall survival of lymphoma patients according human immunodeficiency virus (HIV) status. Methods: We reviewed the pathology database at Instituto Nacional de Enfermedades Neoplasicas (INEN), the leading cancer center of Peru from 2005 to 2014. 6218 cases were lymphomas, 5031 cases were Non-Hodgkin lymphoma and 3905 cases were B-cell lineage. 22 met diagnosis of PBL, 4 patients were excluded (1 prior treatment, 1 synchronous malignancy and 2 incomplete medical records). Finally, we had 18 cases for evaluation. Survival curves were estimated by Kaplan Meier. Statistical analysis was based on SPSS Program version 22. Results: The prevalence of PBL was 0.004% of all Non-Hodgkin lymphomas and 0.005% of B-cell lymphomas. 13 of 18 cases (72.2%) were HIV-positive patients (PBL-HIV+). The median age for PBL-HIV+ was 37 years (range 22-67 years) and 58 years (range 53-74 years) for HIV-negative patients (PBL-HIV-).The extra-oral primary was the most frequent primary site in both groups. The advanced stage was 80% in PBL-HIV- patients. Presence of B-symptoms and Ki-67>80% were greater in PBL-HIV- patients. CHOP or CHOP-like regimen was the common treatment in both groups, only one patient received DA-EPOCH (PBL-HIV+ group). HAART-naïve patients were 77%. The median OS time was 43 months (range 1-84 months) in PBL-HIV+ patients and 13 months (range 0-15 months) in PBL-VIH- patients, the 5-yrs-OS was 26.9% y 0% respectively. Conclusions: Plasmablastic lymphoma is a rare lymphoma, either associated or not to HIV infection. Advanced and aggressive disease is a distinctive feature in both lymphomas. The PBL-HIV- has a worse prognosis with shorter overall survival compared to the PBL-HIV+ patients. Disclosures No relevant conflicts of interest to declare.

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Anolunula in Fingernails among Patients Infected with HIV

ISRN Dermatology ◽

10.1155/2014/271230 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Pratik Gahalaut ◽

Nitin Mishra ◽

Sandhya Chauhan ◽

Mir Mubashir Ali ◽

Madhur Kant Rastogi ◽

...

Keyword(s):

Hiv Infection ◽

Cross Sectional Study ◽

Negative Control ◽

Hiv Positive ◽

Control Group ◽

Cross Sectional ◽

Significant Difference ◽

Stage 1 ◽

And Control ◽

Hiv Negative

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.

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Loco-Regional Treatments for Hepatocellular Carcinoma in People Living with HIV

Infectious Disease Reports ◽

10.3390/idr14010006 ◽

2022 ◽

Vol 14 (1) ◽

pp. 43-55

Author(s):

Cristina Micali ◽

Ylenia Russotto ◽

Grazia Caci ◽

Manuela Ceccarelli ◽

Andrea Marino ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Cancer Staging ◽

Hiv Positive ◽

People Living With Hiv ◽

Liver Cancers ◽

Significant Difference ◽

Cancer Specific Mortality ◽

Living With Hiv ◽

Hiv Negative

Hepatocellular carcinoma (HCC) accounts for approximately 75–90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.

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PD-L1 protein expression and copy number gains in HIV-positive locally advanced cervical cancer

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920963001 ◽

2020 ◽

Vol 12 ◽

pp. 175883592096300

Author(s):

Kongsak Loharamtaweethong ◽

Napaporn Puripat ◽

Niphon Praditphol ◽

Jidapa Thammasiri ◽

Siriwan Tangitgamol

Keyword(s):

Cervical Cancer ◽

Copy Number ◽

Locally Advanced ◽

Hiv Positive ◽

Hiv Status ◽

Free Survival ◽

Parametrial Invasion ◽

Programmed Death ◽

Significant Difference ◽

Hiv Negative

Background: The programmed death-1/programmed death-ligand-1 (PD-1/PD-L1) axis may represent a target for cervical cancer; however, it is poorly understood in human immunodeﬁciency virus (HIV)-infected patients. Methods: We evaluated HIV-positive ( n = 42) and HIV-negative ( n = 110) women with locally advanced cervical cancer regarding their PD-L1 expression, determined by combined positive score (CPS) ⩾ 1 and tumor proportion score (TPS) ⩾ 25%, and PD-L1 copy number alterations, assessed by fluorescence in situ hybridization. Results: Regardless of HIV status, 84.9% and 44.8% of cases were PD-L1-positive according to CPS ⩾ 1 and TPS ⩾ 25%. Per CPS ⩾ 1, PD-L1 positive rate was similar between HIV-positive and HIV-negative women, whereas a significant difference was seen per TPS ⩾ 25%. Tumor size and parametrial invasion were correlated with PD-L1 positivity in HIV-negative women, whereas anti-retroviral therapy (ART) was correlated with TPS < 25%. Low CD4-positive cell counts were associated with CPS < 1 in HIV-positive women. No significant difference was observed in PD-L1 copy number status between HIV-positive and HIV-negative women. PD-L1 amplification and polysomy were independently associated with TPS ⩾ 25%, whereas the presence of parametrial invasion was independently associated with CPS ⩾ 1. Cancer stage and PD-L1 amplification were identified as independent predictors of recurrence-free survival [hazard ratio (HR) = 2.40 (1.32–4.36) and HR = 5.33 (1.94–14.61)] and cancer-specific survival [HR = 13.62 (5.1–36.38) and HR = 3.53 (1.43–8.69)]. PD-L1 polysomy was an independent predictor of locoregional recurrence-free survival [HR = 3.27 (1.27–8.41)]. HIV status and PD-L1 expression (CPS ⩾ 1 or TPS ⩾ 25%) were not associated with poor patient outcomes. Conclusion: PD-L1 amplification and polysomy are the strongest drivers of PD-L1 expression in cervical cancer, and could represent prognostic biomarkers for anti-PD-1/PD-L1 therapy. Cervical cancer biology may be modulated by HIV infection, CD4-positive cells, and HIV treatments.

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Treatment Of Primary Central Nervous System Lymphoma In The HIV-Positive Patient: Should We Be Doing More?

Blood ◽

10.1182/blood.v122.21.4362.4362 ◽

2013 ◽

Vol 122 (21) ◽

pp. 4362-4362

Author(s):

Jeremy Clifton Jones ◽

Harris V. Naina ◽

Yu-Min P Shen

Keyword(s):

Overall Survival ◽

Survival Data ◽

Central Nervous System Lymphoma ◽

Rank Test ◽

Hiv Positive ◽

Immunocompromised Patients ◽

Hiv Status ◽

Tumor Registry ◽

Log Rank Test ◽

Hiv Negative

Abstract Background Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non Hodgkin lymphoma, accounting for approximately 3-4% of new primary brain tumors and approximately 1% of all NHL. The overall incidence of PCNSL is approximately 0.43/100,000 per year, but the relative risk of disease among immunocompromised patients is considerably higher; approximately 3600 times that of the general population. Similarly, the average age of onset, race, treatment regimens and overall survival are all markedly different amongst immunocompetent and immunocompromised patients with PCNSL. The standard treatment for immunocompetent includes high-dose methotrexate based regimens with or without whole brain radiation therapy (WBRT). On the contrary, there is little to no prospective data guiding the treatment of immunocompromised patients with PCNSL. The standard therapy for these patients has yet to be defined, leaving the majority to receive the potentially sub-optimal regimens including WBRT in addition to highly active antiretroviral therapy (HAART). The current study reports on survival data from a retrospective cohort of patients with biopsy-proven PCNSL diagnosed at our institution over the last decade stratified by both HIV status and therapy received. Methods Parkland Memorial Hospital is a 950-bed acute care hospital located in Dallas, Texas. It serves as the county hospital for the city of Dallas as well as the primary teaching site of the University of Texas Southwestern Medical Center. After approval by the institutional review board, we identified patients with biopsy proven PCNSL between 1998 and 2012 at Parkland Memorial Hospital through the institution's tumor registry. After patient identification, the medical records were reviewed for the following patient data: age at diagnosis, ethnicity, sex, HIV status, CD4 cell count, HIV viral load, neuroimaging, treatment (radiation therapy and/or chemotherapy), date of death and date of last contact. Survival data and date of death were obtained from our tumor registry, chart reviews, and social security death index searches. Kaplan–Meier survival curves were constructed and compared between the two groups using the log rank test. Results 40 HIV-positive and 21 HIV-negative patients were included in this retrospective analysis. PCNSL was diagnosed by histological evaluation of biopsy specimens in all 61 patients. Patients were stratified based on their HIV status. Baseline demographic information for the two groups is compared in table 1. Median survival was 21.3 months and 4.6 months for the HIV-negative and HIV-positive cohorts respectively. All HIV-negative patients were treated with HD-MTX based regimens in addition to WBRT (MTX+RT). Of the HIV-positive patients: 28 received WBRT plus HAART (RT+HAART), 7 received no treatment and 5 received HD-MTX based regimens plus WBRT and HAART (MTX+RT+HAART). The average CD4 count at diagnosis in patients who did not receive treatment was 9.1, 50.6 in those who received RT+HAART and 155.8 in those who received MTX+RT+HAART although these differences did not meet statistical significance (p=0.056), (Table 2). HIV-positive patients who received RT+HAART had significantly better overall survival (OS) than those who received no treatment (p-value of log-rank test 0.00023) but worse OS than those who received MTX+RT+HAART (p= 0.0121). There was no difference in OS between HIV-positive patients who received MTX+RT+HAART and HIV-negative patients who received MTX+RT (p= 0.778), (figure 1). Conclusions The data from our current study suggests HIV-positive patients with PCNSL can achieve similar overall survival as their HIV-negative counterparts when they receive similar chemotherapeutic regimens. Furthermore, RT+HAART appears to offer inferior OS to MTX+RT+HAART despite similar baseline CD4 counts. Disclosures: No relevant conflicts of interest to declare.

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Age-related clonal haematopoiesis is more prevalent in older adults with HIV: the ARCHIVE study

10.21203/rs.3.rs-106576/v1 ◽

2020 ◽

Author(s):

Mark Dawson ◽

Nila Dharan ◽

Paul Yeh ◽

Mark Bloch ◽

Miriam Yeung ◽

...

Keyword(s):

Hiv Infection ◽

Age Groups ◽

Selective Advantage ◽

Blood Parameters ◽

Hiv Positive ◽

Hiv Status ◽

Age Related ◽

Potential Risk Factors ◽

Infection And Inflammation ◽

Hiv Negative

Abstract People with HIV have higher rates of certain comorbidities, particularly cardiovascular disease and some malignancies, than people without HIV. As somatic mutations associated with age related clonal haematopoiesis (CH) are linked to similar comorbidities in the general population, we hypothesized that CH may be more prevalent in people with HIV. To address this issue, we established a prospective cohort study recruiting 220 HIV-positive and 226 HIV negative participants aged 55 years or older in Australia. Demographic characteristics, clinical data and peripheral blood were collected to assess for the presence of CH mutations and identify potential risk factors for and clinical sequelae of CH. Investigators testing for CH were blinded to participants’ HIV status. In total, 132 CH mutations were identified in 99 (22.2%) of 446 participants. CH was more prevalent in HIV-positive participants than HIV-negative participants (27.7% vs. 16.8%, p =0.006), overall and across all age groups. HIV infection was associated with an increased odds of having CH (adjusted odds ratio 2.10, 95% confidence interval 1.30-3.38, p=0.002). The most common genes mutated were DNMT3A (48.5%), TET2(20.5%) and ASXL1 (11.4%). CH and HIV infection were independently associated with increases in blood parameters and biomarkers associated with inflammation. These data suggest a selective advantage for the emergence of CH in the context of chronic infection and inflammation related to HIV infection.

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The Prevalence of High Carcinogenic Risk of HPV Genotypes among HIV-Positive and HIV-Negative MSM from Russia

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2021/6641888 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Ilia Beliakov ◽

Maria Senina ◽

Yuriy Tyulenev ◽

Elena Novoselova ◽

Viktor Surovtsev ◽

...

Keyword(s):

High Risk ◽

Hiv Infection ◽

Hpv Infection ◽

Carcinogenic Risk ◽

Hiv Positive ◽

Hiv Status ◽

Hpv Genotypes ◽

Hpv Types ◽

Sex With Men ◽

Hiv Negative

Objective. Men who have sex with men (MSM) have a high risk of lifelong anal cancer caused by high-risk human papillomavirus (HR HPV) infections. The aim of this study was to investigate the prevalence of anal canal HR HPV infection among men who have sex with men (MSM) with and without HIV infection in Moscow (Russia). We evaluated associations of some HIV coinfections (HSV and CMV) and HPV distribution among MSM with and without HIV infection. Methods. Two groups of HIV-positive (n = 60) and HIV-negative (n = 60) MSM were evaluated in the study. Fourteen high-risk (HR) HPV types, HSV1/2, and CMV were investigated in men anal swabs. Results. HR HPVs were found with nearly the same frequency of 66.7% in both groups: HIV-positive and HIV-negative MSM. HIV-positive status was statistically associated with the presence of several (more than two) HPV types ( p = 0.044 ). The most prevalent HR HPV genotypes were HPV18, HPV16, HPV56, and HPV33 for HIV-positive MSM and HPV56, HPV51, HPV66, and HPV16 for HIV-negatives. We found a statistically significant association of five HR HPV types with HIV status of MSM: HPV16 ( p = 0.028 ), HPV18 ( p = 0.00006 ), HPV58 ( p = 0.003 ), HPV33 ( p = 0.019 ), and HPV39 ( p = 0.026 ). The frequency of HSV1 (1.7%) and HSV2 (10%) infections and CMV (3.3%) infection was evaluated in the group of HIV-positive MSM. The frequency of HSV1 (5%) and HSV2 (6.7%) infections and CMV (0%) infection was evaluated, as well, in the group of HIV-negative MSM. Conclusion. Multiple HPV genotypes were detected significantly more often than single HPV genotype in the group of HIV-positive MSM. According to our data, 25% of HIV-positive MSM have HPV39; this is the only one of the five types of HR HPV (16, 18, 58, 33, and 39) associated with this group of MSM that has not yet been included in the HPV vaccines available on the market.

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Age-related clonal haematopoiesis is more prevalent in older adults with HIV: the ARCHIVE study

10.1101/2020.11.19.20235069 ◽

2020 ◽

Author(s):

Nila J. Dharan ◽

Paul Yeh ◽

Mark Bloch ◽

Miriam Yeung ◽

David Baker ◽

...

Keyword(s):

Hiv Infection ◽

Age Groups ◽

Selective Advantage ◽

Blood Parameters ◽

Hiv Positive ◽

Hiv Status ◽

Age Related ◽

Potential Risk Factors ◽

Infection And Inflammation ◽

Hiv Negative

AbstractPeople with HIV have higher rates of certain comorbidities, particularly cardiovascular disease and some malignancies, than people without HIV. As somatic mutations associated with age-related clonal haematopoiesis (CH) are linked to similar comorbidities in the general population, we hypothesized that CH may be more prevalent in people with HIV. To address this issue, we established a prospective cohort study recruiting 220 HIV-positive and 226 HIV-negative participants aged 55 years or older in Australia. Demographic characteristics, clinical data and peripheral blood were collected to assess for the presence of CH mutations and identify potential risk factors for and clinical sequelae of CH. Investigators testing for CH were blinded to participants’ HIV status. In total, 132 CH mutations were identified in 99 (22.2%) of 446 participants. CH was more prevalent in HIV-positive participants than HIV-negative participants (27.7% vs. 16.8%, p =0.006), overall and across all age groups. HIV infection was associated with an increased odds of having CH (adjusted odds ratio 2.10, 95% confidence interval 1.30-3.38, p=0.002). The most common genes mutated were DNMT3A (48.5%), TET2 (20.5%) and ASXL1 (11.4%). CH and HIV infection were independently associated with increases in blood parameters and biomarkers associated with inflammation. These data suggest a selective advantage for the emergence of CH in the context of chronic infection and inflammation related to HIV infection.

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Documentation of HIV Testing and Treatment Status Among Patients Presenting for Cancer Care in Uganda

Journal of Global Oncology ◽

10.1200/jgo.2016.003756 ◽

2016 ◽

Vol 2 (3_suppl) ◽

pp. 58s-58s

Author(s):

Matine J. Ghadrshenas ◽

Rachel A. Bender Ignacio ◽

Daniel H. Low ◽

Warren Phipps ◽

Jackson Orem ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Cancer Patients ◽

Conflicts Of Interest ◽

Hiv Prevalence ◽

Cancer Knowledge ◽

Hiv Status ◽

Hiv Patients ◽

Incidence And Mortality ◽

Hiv Negative

Abstract 23 HIV increases the incidence and mortality of cancer; knowledge of HIV status and treatment is essential for management of patients with HIV-associated malignancies (HIVAM). In Uganda, where the prevalence of HIV infection is 7.4%, the incidence of AIDS-defining cancers (ADCs) is high, and non-AIDS defining cancers (NADCs) are increasingly common. We investigated how often cancer providers documented HIV status and clinical parameters of HIV infection among patients at the Uganda Cancer Institute (UCI). Medical records of patients aged ≥18 who registered at the UCI June - September 2015 were abstracted for demographics and cancer and HIV parameters. We calculated binomial proportions and used χ2 tests to evaluate factors associated with HIV. Among 1,130 patients in this analysis, 71% of charts documented HIV status. Of those documenting HIV status, 32% were HIV+, and 58% of HIV+ individuals had an ADC. The documented HIV prevalence in NADCs was 21%. Women were more likely to lack HIV results (RR 1.32, p=0.009); 36% of women lacked results, including 40% with cervical cancer. HIV+ patients were younger than HIV-negative patients (median age 41 vs. 49, p<0.001). 62% of HIV-infected patients had a CD4 count recorded; CD4 counts were lower among persons with ADC (median 270 cells/ml, IQR 80-460) compared with NADC (median 370, IQR 215-564), p=0.006. There was no difference in the proportion of HIV patients with ADCs and NADCs receiving ART (both 86%, p=0.45). HIV prevalence was 4.5 times higher in Ugandan cancer patients with documented status than in the general population. Though the majority of cancer patients had HIV testing performed, gaps remained in documenting HIV status, even among cancers considered AIDS-defining in HIV. This study highlights opportunities to educate cancer clinicians in Africa on the burden of HIV in cancer patients and opportunities to coordinate management of both cancer and HIV. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Matine J. Ghadrshenas No relationship to disclose Rachel A. Bender Ignacio No relationship to disclose Daniel H. Low No relationship to disclose Warren Phipps No relationship to disclose Jackson Orem No relationship to disclose Ann Duerr No relationship to disclose Corey Casper Leadership: Temptime Consulting or Advisory Role: Janssen Pharmaceuticals Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: Temptime Corporation, GlaxoSmithKline

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Maternal HIV Infection as a Risk Factor for Primary Epstein-Barr Virus Infection in Kenyan Infants

Frontiers in Oncology ◽

10.3389/fonc.2021.805145 ◽

2022 ◽

Vol 11 ◽

Author(s):

Gabriela Samayoa-Reyes ◽

Sidney O. Ogolla ◽

Ibrahim I. Daud ◽

Conner Jackson ◽

Katherine R. Sabourin ◽

...

Keyword(s):

Risk Factor ◽

Viral Load ◽

Breast Milk ◽

Hiv Infection ◽

Post Partum ◽

P Value ◽

Hiv Status ◽

Significant Difference ◽

Maternal Hiv ◽

Hiv Negative

Human immunodeficiency virus (HIV) infection is known to be associated with EBV shedding in saliva suggesting an increased risk of EBV transmission to infants born to mothers with HIV at an earlier age. In this study we investigated (i) whether maternal HIV status was a risk factor for EBV in blood at delivery or for shedding in saliva and breast milk of 6- and 10-weeks post-partum mothers, (ii) if there was a difference in EBV strains shed between HIV+ and HIV- mothers, and (iii) if maternal HIV status was a determinant of EBV viral load in their infants. Samples were collected as part of a prospective cohort study that followed HIV-positive (HIV+) and HIV-negative (HIV-) pregnant women in Western Kenya through delivery and post-partum period. EBV viral load in blood was found to be significantly higher in mothers with HIV (p-value = 0.04). Additionally, a statistically significant difference was observed between EBV viral load in saliva samples and HIV status where HIV+ mothers had a higher EBV viral load in saliva at 6-weeks post-partum compared to HIV- mothers (p-value < 0.01). The difference in EBV shedding in breast milk was not found to be statistically significant. Furthermore, no difference in frequency of EBV strain was attributable to HIV- or HIV+ mothers. Interestingly, we found that infants born to HIV+ mothers had a higher EBV viral load at the time of their first EBV detection in blood than infants born to HIV- mothers and this was independent of age at detection. Overall, our study suggests that HIV infected mothers shed more virus in saliva than HIV-negative mothers and infants born to HIV+ mothers were at risk for loss of control of primary EBV infection as evidenced by higher EBV viral load following primary infection.

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