KSHV DNA viraemia correlates with low CD4+ cell counts in Italian males at the time of diagnosis of HIV infection
Résumé
To evaluate the relevance, virological and immunological markers of Kaposi sarcoma herpesvirus 8 (KSHV) viraemia in Italian male patients at the time of diagnosis of infection with HIV-1, 481 men infected with HIV were recruited consecutively. The presence of KSHV DNA was evaluated in peripheral blood mononuclear cells (PBMCs) and in plasma and correlated with demographic and viro-immunological parameters. Seventy-four patients had KSHV DNA detected in PBMCs. By univariate analysis, the presence of KSHV DNA was associated significantly with unprotected homosexual relationships (p=0.003) and it was significantly higher in patients with CD4+ cell <350 (p=0.025). By multivariate analysis, homosexual relationships were associated independently with KSHVDNA in PBMCs (OR: 3.25; 95% CI: 1.1-9.7; p=0.035). Among the 74 patients with KSHVDNA detected in PBMCs, plasma samples from 60 were analysed and 33 were positive for KSHV DNA. The CD4+ cell counts and percentages were significantly lower in patients with KSHV DNA in both PBMCs and plasma as compared to patients with only KSHV DNA in PBMCs (p=0.006 and p=0.019, respectively). Among the patients with KSHV DNA detected in PBMCs, all 13 patients with CD4+ cells count <200 had detectable levels of KSHV in their plasma. By multivariate analysis adjusted for the epidemiologic and virological parameters, low CD4+ cell count was the only independent variable associated with the presence of KSHV DNA in plasma (OR, 0.001; 95% CI, <0.001-0.001; p=0.03). In HIV-positive antiretroviral therapy-naïve males, KSHV active replication as detected by KSHV DNA in plasma was associated significantly with low CD4+ cell count.
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