Epstein-Barr Virus Infection in a Child With Acquired Immunodeficiency Syndrome

Fackler, James C.; Nagel, James; Adler, William H.; Mildvan, Patricia T; Ambinder, Richard F.

doi:10.1001/archpedi.1985.02140120046026

Cited by 14 publications

(7 citation statements)

References 28 publications

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“…EBV infection has been implicated in the pathogenesis of LIP by correlating onset of symptoms of LIP with EBV seroconversion and showing a possible role of EBV in the lymphocytic proliferation of LIP. 22,23 However, the role of EBV in the pathogenesis of LIP still needs further investigation. 24,25 The predominant HIV subtype in Thailand is E, rather than subtype B which is common in North America and Europe.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Cell Bearing EBER and p24 Antigens in Biopsy-proven Lymphocytic Interstitial Pneumonia in HIV-1 Subtype E Infected Children

Bhoopat

Rangkakulnuwat²,

Ya-In³

et al. 2011

Applied Immunohistochemistry &Amp; Molecular Morphology

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Lymphocytic interstitial pneumonia (LIP) is an uncommon histopathologic entity characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes and other lymphoid elements. An increased incidence of LIP has been seen in the pediatric population, especially in children with acquired immune deficiency syndrome. Our previous study supports the notion that Langerhans cells (LCs) are reservoirs for Epstein-Barr virus (EBV) in lungs of human immunodeficiency virus (HIV) subtype E-infected pediatric LIP. To further understand the pathogenesis of LIP, we studied the relationship between EBV, the suggested causative agent of LIP and HIV-1 capsid protein p24, which play an important role in the interaction with host proteins during HIV-1 adsorption, membrane fusion, and entry in surgical lung biopsy-proven LIP from 9 vertically HIV subtype E-infected pediatric patients. The dominant microscopic feature of LIP demonstrated widespread widening of alveolar septum by mononuclear inflammatory cell infiltrate, mainly composed of mature lymphocytes and plasma cells surrounding airways and expanding to the lung interstitium. EBV-encoded RNA (EBER) in situ hybridization (ISH) and p24 immunohistochemistry, performed on formalin-fixed, paraffin-embedded tissue from open lung biopsy specimens, revealed positive intranuclear EBER signals and intracytoplasmic immunostains for p24 core protein in all 9 LIP cases. By combining ISH and immunohistochemistry, these results suggest that (i) EBV/p24-carrying cells are likely involved in the development of LIP, either directly or indirectly; (ii) LCs and related dendritic cells are the main reservoir of both EBV and HIV subtype E in pediatric LIP and possibly LCs may play an important role in the recruitment of inflammatory cell infiltrates, especially T cells into these tissues; (iii) coexpression of EBV/p24 in bronchioalveolar epithelium supports the hypothesis that these cells serve as a reactivation source for both viruses to achieve greater quantities in alveolar septum and interstitium around bronchioles. These results indicate a strong association between the presence of HIV core protein p24 and expression of EBV RNA transcripts (EBER). Interactions between LCs and related dendritic cells together with T cells are important for effective HIV and EBV replications. The coexpression of both viruses could be related to the evolution of pediatric LIP in HIV subtype E infection.

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Section: Discussionmentioning

confidence: 99%

Relationship of Cell Bearing EBER and p24 Antigens in Biopsy-proven Lymphocytic Interstitial Pneumonia in HIV-1 Subtype E Infected Children

Bhoopat

Rangkakulnuwat²,

Ya-In³

et al. 2011

Applied Immunohistochemistry &Amp; Molecular Morphology

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“…121 Other case reports and matched case-control studies have shown evidence of association between persistent EBV infection and LIP, perhaps as a consequence of EBV and a latent infection in lower respiratory tract. [122][123][124] However, Van Zyl-Smit and colleagues did not find increased prevalence of EBV in HIVinfected LIP patients, and it seems its association is inconsistent. 113 There is also evidence of a possible genetic predisposition for developing LIP.…”

Section: Lymphoid Interstitial Pneumonitismentioning

confidence: 98%

Noninfectious and Nonneoplastic Conditions Associated with Human Immunodeficiency Virus Infection

George

Singh

Gladwin

2016

Semin Respir Crit Care Med

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The goal of this review is to describe evolving epidemiology of noninfectious, nonneoplastic pulmonary complications of HIV infection, including HIV-associated pulmonary arterial hypertension (HIV-PAH) and interstitial lung disease (ILD). The development of antiretroviral therapy has rendered HIV a chronic illness in treated patients, and the landscape of HIV-associated medical conditions continues to evolve. Although there has been a shift away from AIDS-defining infectious diseases and malignancies, HIV-PAH continues to affect survival adversely when compared with HIV-infected patients without PAH. Studies of pre- and post-highly active antiretroviral therapy (HAART) era show that the prevalence of HIV-PAH remains high and unchanged. The increased prevalence of PAH among HIV-infected individuals has led to several complementary theories about potential mechanisms underlying this disease. Unique mechanisms of HIV-PAH focus on direct effects of viral proteins; alterations in cellular immunologic/inflammatory reactions to the virus; additive effects of cocaine, heroin, and other drugs of abuse; and potentially toxic aspects of antiretroviral and associated therapies. PAH-specific therapy with HAART is likely beneficial in the treatment of HIV-PAH patients. The prevalence of ILD in HIV-infected individuals is also significantly higher than that in the general population. Lymphoid interstitial pneumonitis (LIP) and nonspecific interstitial pneumonia (NSIP) have been reported in both HIV-infected children and adults, and NSIP is more common than LIP in HIV-infected patients. At present, there is no consensus on the pathogenesis of LIP and NSIP in HIV. Finally, we briefly review the literature on venous thromboembolic disease in HIV-infected individuals.

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“…Anti-EBV antibodies are also frequently found in recipients of organ transplants and patients with lymphoproliferative diseases. In contrast, some virus-positive individuals produce no serological response (Fackler et al, 1985). Almost all AIDS patients exhibit elevated anti-EBV titers (Ciobanu and Wiernik, 1986;Rinaldo et al, 1986), suggesting that many may harbor infections that are due to viral reactivation facilitated by immunosuppression.…”

Section: Epstein-burr Virusmentioning

confidence: 99%

Viral infections in the acquired immunodeficiency syndrome

Miller

Howell

1988

J. Elec. Microsc. Tech.

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The following communication is a tripartite synopsis of the role of viral infection in the acquired immunodeficiency syndrome (AIDS). The first section describes the impact of viral opportunistic infection in AIDS; for each virus, clinical presentation and diagnosis, laboratory diagnostic approaches (with emphasis on electron microscopy), and therapeutic interventions attempted to date are discussed. The second segment explores current theories on the pathogenesis of AIDS, and describes diagnostic and therapeutic approaches to the syndrome itself. The final section catalogues ultrastructural anomalies in the cells of AIDS patients, many of which have been mistakenly identified as etiologic agents.

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Epstein-Barr Virus Infection in a Child With Acquired Immunodeficiency Syndrome

Cited by 14 publications

References 28 publications

Relationship of Cell Bearing EBER and p24 Antigens in Biopsy-proven Lymphocytic Interstitial Pneumonia in HIV-1 Subtype E Infected Children

Relationship of Cell Bearing EBER and p24 Antigens in Biopsy-proven Lymphocytic Interstitial Pneumonia in HIV-1 Subtype E Infected Children

Noninfectious and Nonneoplastic Conditions Associated with Human Immunodeficiency Virus Infection

Viral infections in the acquired immunodeficiency syndrome

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