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Herpesvirus type 1–8 in BAL fluid from HIV-1-infected patients with suspected pneumonia and from healthy individuals

¹ Dept of Infectious Diseases, Marselisborg Hospital, Aarhus University Hospital, and ² Dept of Respiratory Diseases, Aarhus University Hospital, Aarhus C, Denmark

CORRESPONDENCE: B. Tarp, Dept of Infectious Diseases, Marselisborg Hospital, Aarhus University Hospital, DK-8000, Aarhus C, Denmark. Fax: 45 89491800

Keywords: bronchoalveolar lavage, herpesvirus, human immunodeficiency virus/acquired immune deficiency syndrome, pneumonia, polymerase chain reaction

Received: October 18, 2000
Accepted February 13, 2001

This work was supported by grants from the Danish Lung Association, AIDS-Fondet, and Aarhus University Research Foundation.

Pneumonia is still a major problem in human immunodeficiency virus (HIV)-infected patients, and despite extensive investigation the aetiology remains unknown in many cases. The prevalence of the eight human herpesviruses was determined by polymerase chain reaction in 91 samples of bronchoalveolar lavage (BAL) fluid from 72 HIV-infected patients with 91 episodes of suspected pneumonia. The presence of herpesviruses was related to clinical and immunological findings and the prevalence of herpesviruses in HIV-infected patients was compared with the prevalence in BAL fluid from 50 healthy, immunocompetent individuals.

Epstein-Barr virus, cytomegalovirus and human herpesvirus-8 (HHV8) were found in 5.5%, 36%, and 5.5% of BAL fluid samples from HIV-infected patients. No herpesviruses were detectable in BAL fluid from healthy, immunocompetent individuals. The herpesviruses occurred mainly in patients with CD4+ counts <200x10⁶ L^–1. All patients with herpesviruses recovered without specific antiviral treatment. Two patients with HHV8 had the diagnosis of Kaposi's sarcoma.

It is concluded that cytomegalovirus, Epstein-Barr virus, and human herpesvirus-8 are frequently present in bronchoalveolar lavage fluid from severely immunocompromised human immunodeficiency virus-infected patients with pulmonary symptoms. In bronchoalveolar lavage fluid from healthy, immunocompetent individuals, herpesviruses are absent. Apart from human herpesvirus-8, the present results indicate that the herpesviruses do not play a serious pathogenic role in the development of pulmonary symptoms in human immunodeficiency virus-infected patients.