A longitudinal and prospective study of Epstein-Barr virus load in AIDS-related non-Hodgkin lymphoma

Background Epstein-Barr virus (EBV) may be causally associated with non-Hodgkin Lymphoma (NHL) in HIV-infected patients. Objectives To compare EBV load in whole blood in AIDS-NHL patients, HIV non-AIDS patients and non-HIV-infected persons, and to prospectively measure EBV load in whole blood in AIDS-NHL patients. Study design Longitudinal and prospective study. Results We observed no statistical difference in EBV load between AIDS-NHL (3.69log 10 copies/mL [interquartile range (IQR): 2.89–4.27]) and HIV non-AIDS patients (3.08log 10 copies/mL [IQR: 1.29–3.57]) but AIDS-NHL patients had significantly higher EBV loads than HIV-negative controls (1.19log 10 copies/mL [IQR: 0.00–3.29]). We noticed an inverse correlation between CD4+ lymphocytes count and EBV load in patients with AIDS-NHL ( r 2 =0.41, P =0.01). In the longitudinal study, the mean EBV load three months after NHL diagnosis decreased significantly (mean difference=−1.69log 10 copies/mL [95% confidence interval: −0.32; −3.04]; P =0.03) under chemotherapy but was still elevated in patients with relapses or no response to chemotherapy. Conclusion Although EBV load seems a suboptimal marker for the diagnosis of AIDS-NHL, we observed a significant decrease of EBV load in patients treated with chemotherapy and a strong association between NHL outcome and EBV load in whole blood.