Assessment of γ-herpesvirus infection dynamics in non-hospitalised people living with HIV during the COVID-19 pandemic in South Africa.

Publication date: Oct 01, 2025

Epstein-Barr virus (EBV) and Kaposi’s sarcoma-associated herpesvirus (KSHV) are oncogenic human γ-herpesviruses highly prevalent in Sub-Saharan Africa. Both establish latent early-life infections, with intermittent lytic reactivations, often triggered by viral co-infections, particularly in immunocompromised individuals. In this retrospective observational cross-sectional sub-study, we leveraged a cohort of 407 non-hospitalised people living with HIV (PLWH) attending antiretroviral therapy services in South Africa during the COVID-19 pandemic, with previously reported increased reactivation of KSHV upon SARS-CoV-2 exposure, particularly in COVID-19 unvaccinated individuals (Lambarey et al. , 2024). In contrast to the generally low KSHV viral loads (VL), we observed high detectability (97. 0 %) of EBV DNA in the patients’ peripheral blood, with 12. 4 % of patients displaying elevated EBV VL of ≥1 cD7 10 copies/10 cells. However, neither SARS-CoV-2 exposure nor COVID-19 vaccination had an impact on EBV reactivation. Interestingly, patients with chronically elevated EBV VL had higher detectability of KSHV VL (35. 0 %) compared to the remainder of the cohort with undetectable or

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