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Title: Recrudescence of persistent viruses as a potential marker of immunodeficiency
Author: Compston, L. I.
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2009
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Objective: To test the hypothesis that the viraemia pattern of common latent and persistent viruses is ubiquitous to immunodeficiency in general, and can therefore serve as surrogate marker of immunocompetence. Design: A cross-sectional case-control design was used. The elderly, HIV and blood donor cohorts were recruited from Kumasi Teaching Hospital, Ghana, and the autoimmune archived samples from Addenbrooke’s hospital, UK. Results: Common viraemia profiles were shared between HIV-1 and age-related immunodeficiency. EBV had significant OR of reactivation in the elderly, and all stages of HIV, while CMV was only relevant to the elderly and AIDS patients. Detection in either cellular or plasma fraction was informative of reactivation of EBV only. Although no viraemia was detected for VZV, there was a significant increase in seroprevalence suggestive of reactivation in all HIV stages and in the elderly. B19V viraemia was specific to the elderly, while HBV (OBI) and GBV-C viraemia and indirect evidence of possible HHV-8 reactivation (increased seroprevalence) were specific only to HIV. In the autoimmune cohorts there was a complete absence of viraemia, and no significant change in seroprevalence for any virus screened. Although below significance there was a trend of anti-VZV antibody loss in the ANCA-associated small vessel vasculitis, additionally past-exposure to GBV-C was only observed in Microscopic Polyangitis. Conclusions: While evidence for the hypothesis of generality of reactivation of persistent viruses was apparently unfounded, as GBV-C and HBV were specific for HIV and B19V specific for the elderly, there was however some evidence for a general reactivation profile (in Ghana) of the latent herpesviruses, with EBV and CMB showing significant reactivation (viraemia) and potential VZV reactivation suggested by increased seroprevalence.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available