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Lassina TRAORE
Abdoul Karim OUATTARA
Tegwindé Rébéca COMPAORE
Serge Théophile SOUBEIGA
Pegdwendé Abel SORGHO
Florencia Wendkuuni DJIGMA
Albert Théophane YONLI


EBV, HHV-6, HIV-1, subtype, CD4 T cell count, viral load and treatment


Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6) are responsible for severe diseases, particularly in immunocompromised persons. There are poor data on the infection with these opportunistic viruses in Burkina Faso.

The purpose of this study is to characterize EBV and HHV-6 subtypes and to assess their impact on CD4 T cell count, HIV-1 viral load and antiretroviral treatment in people living with HIV-1.

The study population consisted of 238 HIV-positive patients with information on CD4 count, HIV-1 viral load and HAART. Venous blood samples collected on EDTA tubes were used for EBV and HHV-6 Real Time PCR subtyping.

An infection rate of 6.7% (16/238) and 7.1% (17/238) were found respectively for EBV and HHV-6 in the present study. Among EBV infections, similar prevalences were noted for both subtypes (3.9% [9/238] for EBV-1 vs 4.6% [11/238] for EBV-2) with 2.1% (5/238) of co-infection. HHV-6A infection represented 6.3% (15/238) of the study population against 5.0% (12/238) for HHV-6B. . EBV-2 infection was significantly higher in patients with CD4 count ? 500 compared to those with CD4 count less than 500 cells (1.65% vs 8.56%, p = 0,011). The prevalence of EBV and HHV-6 infections were almost similar in HAART-naive and HAART-experienced patients.

The present study provides information on the prevalence of EBV and HHV-6 subtypes in people living with HIV-1 in Burkina Faso. The study also suggests that HAART treatment has no effect on infection with these opportunistic viruses in people living with HIV-1.


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[1] Damania B. Oncogenic gamma-herpesviruses: comparison of viral proteins involved in tumorigenesis. Nat Rev Microbiol. 2004; 28:656-668.

[2] Balfour HH, Jr., Odumade OA, Schmeling DO, Mullan BD, Ed JA, Knight JA, Vezina HE, Thomas W, Hogquist KA. Behavioral, virologic, and immunologic factors associated with acquisition and severity of primary Epstein-Barr virus infection in university students. J Infect Dis. 2013; 2071:80-88.

[3] Bagan L, Ocete-Monchon MD, Leopoldo-Rodado M, Murillo-Cortes J, Diaz-Fernandez JM, Medina-Gonzalez R, Gimeno-Cardona C, Bagan JV. Prevalence of salivary Epstein-Barr virus in potentially malignant oral disorders and oral squamous cell carcinoma. Med Oral Patol Oral Cir Bucal. 2016; 212:e157-160.

[4] Macsween KF, Crawford DH. Epstein-Barr virus-recent advances. Lancet Infect Dis. 2003; 33:131-140.

[5] Godshall SE, Kirchner JT. Infectious mononucleosis. Complexities of a common syndrome. Postgrad Med. 2000; 1077:175-179, 183-174, 186.

[6] Wang X, Yang K, Wei C, Huang Y, Zhao D. Coinfection with EBV/CMV and other respiratory agents in children with suspected infectious mononucleosis. Virol J. 2010; 7:247.

[7] Burkitt D. A sarcoma involving the jaws in African children. Br J Surg. 1958; 46197:218-223.

[8] Flavell KJ, Murray PG. Hodgkin's disease and the Epstein-Barr virus. Mol Pathol. 2000; 535:262-269.

[9] Adjei AA, Armah HB, Gbagbo F, Boamah I, Adu-Gyamfi C, Asare I. Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa. BMC Infect Dis. 2008; 8:111.

[10] Iizasa H, Nanbo A, Nishikawa J, Jinushi M, Yoshiyama H. Epstein-Barr Virus (EBV)-associated gastric carcinoma. Viruses. 2012; 412:3420-3439.

[11] Webster-Cyriaque J, Middeldorp J, Raab-Traub N. Hairy leukoplakia: an unusual combination of transforming and permissive Epstein-Barr virus infections. J Virol. 2000; 7416:7610-7618.

[12] Munz C, Lunemann JD, Getts MT, Miller SD. Antiviral immune responses: triggers of or triggered by autoimmunity? Nat Rev Immunol. 2009; 94:246-258.

[13] Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013; 496:1374-1403.

[14] van Baarle D, Hovenkamp E, Callan MF, Wolthers KC, Kostense S, Tan LC, Niesters HG, Osterhaus AD, McMichael AJ, van Oers MH, Miedema F. Dysfunctional Epstein-Barr virus (EBV)-specific CD8(+) T lymphocytes and increased EBV load in HIV-1 infected individuals progressing to AIDS-related non-Hodgkin lymphoma. Blood. 2001; 981:146-155.

[15] Mazeron M-C, Amiel C, Agut H. Mesure et interprétation des charges virales dans les infections à herpèsvirus humains (cytomégalovirus, virus Epstein-Barr, herpèsvirus humains 6 et 8). Revue Francophone des Laboratoires. 2016; 2016487:47-54.

[16] Ablashi D, Agut H, Alvarez-Lafuente R, Clark DA, Dewhurst S, DiLuca D, Flamand L, Frenkel N, Gallo R, Gompels UA, Hollsberg P, Jacobson S, Luppi M, Lusso P, Malnati M, Medveczky P, Mori Y, Pellett PE, Pritchett JC, Yamanishi K, Yoshikawa T. Classification of HHV-6A and HHV-6B as distinct viruses. Arch Virol. 2014; 1595:863-870.

[17] De Bolle L, Naesens L, De Clercq E. Update on human herpesvirus 6 biology, clinical features, and therapy. Clin Microbiol Rev. 2005; 181:217-245.

[18] Thader-Voigt A, Jacobs E, Lehmann W, Bandt D. Development of a microwell adapted immunoblot system with recombinant antigens for distinguishing human herpesvirus (HHV)6A and HHV6B and detection of human cytomegalovirus. Clin Chem Lab Med. 2011; 4911:1891-1898.

[19] Bates M, Monze M, Bima H, Kapambwe M, Clark D, Kasolo FC, Gompels UA. Predominant human herpesvirus 6 variant A infant infections in an HIV-1 endemic region of Sub-Saharan Africa. J Med Virol. 2009; 815:779-789.

[20] Caserta MT, Mock DJ, Dewhurst S. Human herpesvirus 6. Clin Infect Dis. 2001; 336:829-833.

[21] Salahuddin SZ, Ablashi DV, Markham PD, Josephs SF, Sturzenegger S, Kaplan M, Halligan G, Biberfeld P, Wong-Staal F, Kramarsky B, et al. Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science. 1986; 2344776:596-601.

[22] Torelli G, Marasca R, Luppi M, Selleri L, Ferrari S, Narni F, Mariano MT, Federico M, Ceccherini-Nelli L, Bendinelli M, et al. Human herpesvirus-6 in human lymphomas: identification of specific sequences in Hodgkin's lymphomas by polymerase chain reaction. Blood. 1991; 7710:2251-2258.

[23] Descamps V, Valance A, Edlinger C, Fillet AM, Grossin M, Lebrun-Vignes B, Belaich S, Crickx B. Association of human herpesvirus 6 infection with drug reaction with eosinophilia and systemic symptoms. Arch Dermatol. 2001; 1373:301-304.

[24] Lusso P, Ensoli B, Markham PD, Ablashi DV, Salahuddin SZ, Tschachler E, Wong-Staal F, Gallo RC. Productive dual infection of human CD4+ T lymphocytes by HIV-1 and HHV-6. Nature. 1989; 3376205:370-373.

[25] Kositanont U, Wasi C, Wanprapar N, Bowonkiratikachorn P, Chokephaibulkit K, Chearskul S, Chimabutra K, Sutthent R, Foongladda S, Inagi R, Kurata T, Yamanishi K. Primary infection of human herpesvirus 6 in children with vertical infection of human immunodeficiency virus type 1. J Infect Dis. 1999; 1801:50-55.

[26] Emery VC, Atkins MC, Bowen EF, Clark DA, Johnson MA, Kidd IM, McLaughlin JE, Phillips AN, Strappe PM, Griffiths PD. Interactions between beta-herpesviruses and human immunodeficiency virus in vivo: evidence for increased human immunodeficiency viral load in the presence of human herpesvirus 6. J Med Virol. 1999; 573:278-282.

[27] Fairfax MR, Schacker T, Cone RW, Collier AC, Corey L. Human herpesvirus 6 DNA in blood cells of human immunodeficiency virus-infected men: correlation of high levels with high CD4 cell counts. J Infect Dis. 1994; 1696:1342-1345.

[28] Knox KK, Harrington DP, Carrigan DR. Fulminant human herpesvirus six encephalitis in a human immunodeficiency virus-infected infant. J Med Virol. 1995; 453:288-292.

[29] Nigro G, Luzi G, Krzysztofiak A, D'Orio F, Aiuti F. Detection of IgM antibodies to human herpesvirus 6 in Romanian children with nonprogressive human immunodeficiency virus disease. Pediatr Infect Dis J. 1995; 1410:891-894.

[30] Qavi HB, Green MT, Lewis DE, Hollinger FB, Pearson G, Ablashi DV. HIV-1 and HHV-6 antigens and transcripts in retinas of patients with AIDS in the absence of human cytomegalovirus. Invest Ophthalmol Vis Sci. 1995; 3610:2040-2047.

[31] Reux I, Fillet AM, Agut H, Katlama C, Hauw JJ, LeHoang P. In situ detection of human herpesvirus 6 in retinitis associated with acquired immunodeficiency syndrome. Am J Ophthalmol. 1992; 1143:375-377.

[32] Tao I, Bisseye C, Nagalo BM, Sanou M, Kiba A, Surat G, Compaore TR, Traore L, Nikiema JB, Pietra V, Zongo JD, Simpore J. Screening of Hepatitis G and Epstein-Barr Viruses Among Voluntary non Remunerated Blood Donors (VNRBD) in Burkina Faso, West Africa. Mediterr J Hematol Infect Dis. 2013; 51:e2013053.

[33] Traore L, Tao I, Bisseye C, Diarra B, Compaore TR, Nebie Y, Assih M, Ouedraogo A, Zohoncon T, Djigma F, Ouermi D, Barro N, Sanou M, Ouedraogo RT, Simpore J. Molecular diagnostic of cytomegalovirus, Epstein Barr virus and Herpes virus 6 infections among blood donors by multiplex real-time PCR in Ouagadougou, Burkina Faso. Pan Afr Med J. 2016; 24:298.

[34] Ouedraogo AR, Kabre M, Bisseye C, Zohoncon TM, Asshi M, Soubeiga ST, Diarra B, Traore L, Djigma FW, Ouermi D, Pietra V, Barro N, Simpore J. [Molecular tests in diagnosis of Cytomegalovirus (CMV), human herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV) using real-time PCR in HIV positive and HIV-negative pregnant women in Ouagadougou, Burkina Faso]. Pan Afr Med J. 2016; 24:223.

[35] Miller SA, Dykes DD, Polesky HF. A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res. 1988; 163:1215.

[36] Kwok H, Chan KW, Chan KH, Chiang AK. Distribution, persistence and interchange of Epstein-Barr virus strains among PBMC, plasma and saliva of primary infection subjects. PLoS One. 2015; 103:e0120710.

[37] Yavarian J, Shatizadeh Malekshahi S, Yavarian R, Yazdani S, Janani L, Shafiei Jandaghi NZ, Kiani SJ, Ahamadkhaniha H. Type specific Real time PCR for detection of human herpes virus 6 in schizophrenia and bipolar patients: a case control study. BMC Psychiatry. 2015; 15:296.

[38] Abdel-Hamid M, Chen JJ, Constantine N, Massoud M, Raab-Traub N. EBV strain variation: geographical distribution and relation to disease state. Virology. 1992; 1901:168-175.

[39] Chang CM, Yu KJ, Mbulaiteye SM, Hildesheim A, Bhatia K. The extent of genetic diversity of Epstein-Barr virus and its geographic and disease patterns: a need for reappraisal. Virus Res. 2009; 1432:209-221.

[40] Correa RM, Fellner MD, Alonio LV, Durand K, Teyssie AR, Picconi MA. Epstein-barr virus (EBV) in healthy carriers: Distribution of genotypes and 30 bp deletion in latent membrane protein-1 (LMP-1) oncogene. J Med Virol. 2004; 734:583-588.

[41] Falk KI, Zou JZ, Lucht E, Linde A, Ernberg I. Direct identification by PCR of EBV types and variants in clinical samples. J Med Virol. 1997; 514:355-363.

[42] 42. Kunimoto M, Tamura S, Tabata T, Yoshie O. One-step typing of Epstein-Barr virus by polymerase chain reaction: predominance of type 1 virus in Japan. J Gen Virol. 1992; 73 ( Pt 2):455-461.

[43] Sixbey JW, Shirley P, Chesney PJ, Buntin DM, Resnick L. Detection of a second widespread strain of Epstein-Barr virus. Lancet. 1989; 28666:761-765.

[44] Sculley TB, Apolloni A, Hurren L, Moss DJ, Cooper DA. Coinfection with A- and B-type Epstein-Barr virus in human immunodeficiency virus-positive subjects. J Infect Dis. 1990; 1623:643-648.

[45] van Baarle D, Hovenkamp E, Kersten MJ, Klein MR, Miedema F, van Oers MH. Direct Epstein-Barr virus (EBV) typing on peripheral blood mononuclear cells: no association between EBV type 2 infection or superinfection and the development of acquired immunodeficiency syndrome-related non-Hodgkin's lymphoma. Blood. 1999; 9311:3949-3955.

[46] Yao QY, Tierney RJ, Croom-Carter D, Dukers D, Cooper GM, Ellis CJ, Rowe M, Rickinson AB. Frequency of multiple Epstein-Barr virus infections in T-cell-immunocompromised individuals. J Virol. 1996; 708:4884-4894.

[47] Walling DM, Brown AL, Etienne W, Keitel WA, Ling PD. Multiple Epstein-Barr virus infections in healthy individuals. J Virol. 2003; 7711:6546-6550.

[48] Baillargeon J, Piper J, Leach CT. Epidemiology of human herpesvirus 6 (HHV-6) infection in pregnant and nonpregnant women. J Clin Virol. 2000; 163:149-157.

[49] Piriou E, Jansen CA, van Dort K, De Cuyper I, Nanlohy NM, Lange JM, van Oers MH, Miedema F, van Baarle D. Reconstitution of EBV latent but not lytic antigen-specific CD4+ and CD8+ T cells after HIV treatment with highly active antiretroviral therapy. J Immunol. 2005; 1753:2010-2017.

[50] Ensoli B, Lusso P, Schachter F, Josephs SF, Rappaport J, Negro F, Gallo RC, Wong-Staal F. Human herpes virus-6 increases HIV-1 expression in co-infected T cells via nuclear factors binding to the HIV-1 enhancer. EMBO J. 1989; 810:3019-3027.

[51] Lusso P, De Maria A, Malnati M, Lori F, DeRocco SE, Baseler M, Gallo RC. Induction of CD4 and susceptibility to HIV-1 infection in human CD8+ T lymphocytes by human herpesvirus 6. Nature. 1991; 3496309:533-535.

[52] Lusso P, Malnati MS, Garzino-Demo A, Crowley RW, Long EO, Gallo RC. Infection of natural killer cells by human herpesvirus 6. Nature. 1993; 3626419:458-462.