Natural History of Primary Epstein‐Barr Virus Infection in Children of Mothers Infected with Human Immunodeficiency Virus Type 1

• Type of Material: Article
• Authors: Hal Jenson, University of Texas; Kenneth McIntosh, Texas Children's Hospital; Jane Pitt, Baylor College of Medicine; Scott Husak, Children's Hospital, Boston; Ming Tan, Columbia University; Yvonne Bryson, Cleveland Clinic Foundation; William Shearer, UCLA School of Medicine; Kirk Easley, Emory University
• Language: English
• Date: 1999-06
• Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option C
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: 1999, Oxford University Press
• Final Published Version (URL): http://dx.doi.org/10.1086/314764
• Title of Journal or Parent Work: Journal of Infectious Diseases
• ISSN: 0022-1899
• Volume: 179
• Issue: 6
• Start Page: 1395
• End Page: 1404
• Grant/Funding Information: Financial support: NIH (contracts HR-96037, -96038, -96039, -96040, -96041, -96042, -96043; grants RR-00188, -02172, -00533, -00071, -00645, -00865, -00043).
• Research Categories: Health Sciences, Immunology; Health Sciences, Epidemiology; Biology, Biostatistics

Abstract

The natural history of Epstein-Barr virus (EBV) infection in 556 infants born to 517 human immunodeficiency virus (HIV) type 1—infected mothers was studied in a prospective, multi- center, cohort study. HIV-1—infected children had a cumulative EBV infection rate similar to HIV-1—uninfected children at age 3 years (77.8% vs. 84.9%) but had more frequent oropharyngeal EBV shedding (50.4% vs. 28.2%; P <.001). The probability of shedding decreased with longer time from EBV seroconversion and was similar to that of HIV-1-uninfected children 3 years after seroconversion. HIV-1—infected children identified as rapid progressors shed EBV more frequently than nonrapid progressors (69.4% vs.41.0%; P = .01). HIV-1-infected children with EBV infection had higher mean CD8 cell counts. EBV infection did not have an independent effect on mean CD4 cell counts, percent CD4, IgG levels, HIV-1 RNA levels, lymphadenopathy, hepatomegaly, or splenomegaly. Early EBV infection is common in children born to HIV-1-infected mothers. Children with rapidly progressive HIV-1 disease have more frequent EBV shedding.