CMV and EBV DNA is associated with increasing HIV DNA Molecular Diversity in Peripheral Blood during Suppressive Antiretroviral Therapy

As part of this study we evaluated the molecular characteristics of the HIV DNA reservoir over time during antiretroviral treatment (ART) in relation to other chronic viral infections (i.e. Cytomegalovirus [CMV] and Epstein-Barr Virus [EBV]). We demonstrated that presence of CMV and high-level EBV DNA in peripheral blood cells was associated with changes in HIV DNA molecular diversity. Specifically, diversity levels tended to increase over time among participants with detectable CMV and high-level EBV DNA, while they significantly declined among participants with no/low viral shedding. Although the current study design does not allow causality to be inferred, it does support the theory that persistent CMV and EBV replication could contribute to the dynamics of the HIV DNA reservoir during suppressive ART even when ART is initiated during the earliest phases of HIV infection.