Abstract: Objective To investigate the influencing factors and related immune marker characteristics of co-infection with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in patients with HIV infection/AIDS, so as to provide a reference for early clinical screening, diagnosis and treatment. Method Clinical data of 384 patients with HIV infection/AIDS were retrospectively collected from January 1 to December 31, 2024 at the Second Hospital of Nanjing. Peripheral blood CD4⁺T lymphocyte count was detected by flow cytometry, and loads of HIV RNA, EBV DNA and CMV DNA were measured by real-time fluorescent quantitative polymerase chain reaction. Multivariate Logistic regression was used to analyze the influencing factors of EBV and CMV co-infection. Spearman rank correlation was applied to evaluate the correlation between CD4⁺T lymphocyte count and HIV RNA load. Result Among the 384 HIV/AIDS patients, 80 had EBV and CMV co-infection, with a co-infection rate of 20.8%. The difference in co-infection rate among groups with different CD4⁺T lymphocyte counts was statistically significant (χ²=42.573, P<0.001). Multivariate Logistic regression analysis showed that age >50 years, CD4⁺T lymphocyte count <200 cells/μl, and HIV RNA load ≥200 copies/ml were independent risk factors for EBV and CMV co-infection (all P<0.05). Correlation analysis revealed that CD4⁺T lymphocyte count was negatively correlated with HIV-RNA load in HIV-EBV-CMV co-infected patients (r=-0.336, P=0.002). Conclusion Age >50 years, CD4⁺T lymphocyte count <200 cells/μl and HIV RNA load ≥200 copies/ml increase the risk of EBV and CMV co-infection in HIV-infected/AIDS patients, and co-infection can further aggravate immune impairment. Active screening, early identification and timely intervention should be carried out for such high-risk populations to improve the prognosis.

Key words: Human immunodeficiency virus, Acquired immune deficiency syndrome, Epstein-Barr virus, Cytomegalovirus, Co-infection, CD4⁺T lymphocyte count, Viral load