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Abstract
To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.
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Details
1 Federal University of Pará, Laboratory of Virology, Institute of Biological Sciences, Belém, Brazil (GRID:grid.271300.7) (ISNI:0000 0001 2171 5249)
2 Evandro Chagas Institute, Epstein-Barr Virus Laboratory, Virology Section, Ananindeua, Brazil (GRID:grid.419134.a) (ISNI:0000 0004 0620 4442)
3 Evandro Chagas Institute, Department of Epidemiology and Surveillance, Ananindeua, Brazil (GRID:grid.419134.a) (ISNI:0000 0004 0620 4442)
4 Evandro Chagas Institute, Laboratory of Retroviruses, Ananindeua, Brazil (GRID:grid.419134.a) (ISNI:0000 0004 0620 4442)
5 Evandro Chagas Institute, Epstein-Barr Virus Laboratory, Virology Section, Ananindeua, Brazil (GRID:grid.419134.a) (ISNI:0000 0004 0620 4442); Federal University of Pará, School of Medicine, Belém, Brazil (GRID:grid.271300.7) (ISNI:0000 0001 2171 5249)
6 Evandro Chagas Institute, Epstein-Barr Virus Laboratory, Virology Section, Ananindeua, Brazil (GRID:grid.419134.a) (ISNI:0000 0004 0620 4442); Federal University of Pará, Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Belém, Brazil (GRID:grid.271300.7) (ISNI:0000 0001 2171 5249)
7 Federal University of Pará, Laboratory of Virology, Institute of Biological Sciences, Belém, Brazil (GRID:grid.271300.7) (ISNI:0000 0001 2171 5249); Federal University of Pará, Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Belém, Brazil (GRID:grid.271300.7) (ISNI:0000 0001 2171 5249)