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BMC Infect Dis. 2016 Jan 25;16:24. doi: 10.1186/s12879-016-1356-y.

Genital Epstein Barr Virus is associated with higher prevalence and persistence of anal human papillomavirus in HIV-infected men on antiretroviral therapy.

Author information

1
University of California San Diego, 500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA. gianella@ucsd.edu.
2
North Shore-LIJ Health System, Lake Success, NY, USA. cginocch@gmail.com.
3
Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. cginocch@gmail.com.
4
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA. edaar@labiomed.org.
5
University of Southern California Keck School of Medicine, 1300 N. Mission Road, Suite 349, Los Angeles, CA 91106, CA, USA. mdube@med.usc.edu.
6
University of California San Diego, 500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA. shmorris@ucsd.edu.
7
University of California San Diego, 200 Arbor Dr., Mail code 8208, San Diego, CA, 92103, USA. shmorris@ucsd.edu.

Abstract

BACKGROUND:

Epstein Barr virus (EBV) and human papillomavirus (HPV) can co-exist in pharyngeal and cervical malignancies. However, the natural history and factors associated with persistent HPV infection among HIV-infected men who have sex with men (MSM) are unclear.

METHODS:

131 HIV-infected MSM were followed for 48 weeks and screened for multiple co-infections, including seminal EBV DNA and high risk (HR)-HPV messenger RNA (mRNA) at several sites (semen, anal, pharynx). Primary analysis tested if seminal EBV shedding was associated with increased prevalence of HR-HPV at baseline using univariate tests and multivariable logistic regression. In participants with detectable anal HR-HPV at baseline, we tested if presence of seminal EBV shedding at baseline was also predictive of reduced HR-HPV clearance by log-rank test (over 48 weeks of follow-up).

RESULTS:

Baseline prevalence of HR-HPV was: anal 44% (N = 54/121); pharynx 3.8% (N = 5/131); semen 7.1% (N = 7/98). Seminal EBV shedding was present in 28% of participants and was associated with more than double the prevalence of detectable anal HR-HPV mRNA (71.4% for EBV shedders versus 33.3% for non-shedders, p < 0.01). In participants with detectable anal HR-HPV at baseline, we found increased persistence of HR-HPV over 48 weeks of follow-up (measured as time to first negative HR-HPV test in the EBV shedding group (p < 0.01).

CONCLUSIONS:

Seminal EBV shedding was associated with an increased risk of having detectable anal HR-HPV in a cohort of HIV-infected MSM on suppressive ART. Future studies should examine if co-infection with EBV and HR-HPV may act synergistically in pathogenesis of anal cancer in HIV-infected individuals.

PMID:
26809559
PMCID:
PMC4727320
DOI:
10.1186/s12879-016-1356-y
[Indexed for MEDLINE]
Free PMC Article

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