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. Current findings from this study indicate that reactivated type EBV infections are particularly prominent in the initial stages of the underlying HIV-1 infection. However, serologic response to EBV remains quite intense and abnormal through-out the early and late stages of the HIV-1 infection. The serologic findings are reflective of the abnormally elevated burden of transforming EBV present in oropharyngeal secretions and peripheral blood lymphocytes of patients with HIV-1 infection in all WR classes. Interestingly, the replicating form of the virus remains at highly elevated stages, i.e. Walter Reed classes 5 and 6. These high levels of EBV should be directly responsible for the emergence of EBV-related manifestations such as lymphoproliferative lesions and the increasing number of B cell lymphomas being reported in HIV-1 infected individuals. The tongue lesions, oral hairy leukoplakia, which may portend a poorer prognosis of the underlying HIV infection, represent a recently defined example of the EBV-related lesion containing an extremely high level of replicating EBV. The mechanismsresponsible for the immunodysregulation of EBV in patients with HIV infections that permit the development of these EBV-related lesions is being investigated. SDW