The Definition of Epstein Barr Virus (EBV)'s Role in HTLV-III Infected USAF Personnel as Related to Disease Progression

The main objective of this study was to define the role of EBV in the progressive evolution of AIDS by means of a prospective evaluation of persons with HIV infections. Detailed EBV antibody responses and virologic studies to determine the EBV load in body fluids and EBV strains were performed serially. The possible concurrent presence of HIV in EBV cell cultures established from body fluids from HIV infected persons also was examined. The HIV infected participants had an enhanced antibody response to a broad spectrum of EBV antigens. In addition, an increased amount of EBV was detected in oropharyngeal secretions as well as an increased proliferative ability of peripheral blood mononuclear cells compared to normal, healthy adults. The consequences of this highly increased burden of EBV in HIV patients are not well understood but could support the possibility that EBV may be a stimulus to produce tumors or other lymphoproliferative manifestations. The subgroup of patients with oral hairy leukoplakia OHL had an overall body burden of EBV, including a high density of replicating virus in the oral lesions, and more abnormal EBV antibody responses than HIV-infected personnel lacking OHL. This finding further strengthened the speculation that EBV is not well immunoregulated in HIV-infected patients and can lead to various lesions, some as lymphomas reported by others being quite deleterious. No correlation was noted between specific EBV genotypes and progression of the HIV infection, but the numbers tested and the changes in disease progression were small at this point in the study.