EBV is a herpesvirus that causes infectious mononucleosis and is associated with cancers like Burkitt's lymphoma and nasopharyngeal carcinoma. It infects B lymphocytes and epithelial cells, and can establish a latent infection in B cells. Primary infection often causes asymptomatic or mild illness, while reactivation can sometimes occur in immunosuppressed individuals. EBV is diagnosed through viral culture, serology to detect antibodies, or detecting viral DNA through molecular techniques. It is very common worldwide, though patterns of infection and disease manifestation vary between developed and developing areas.
EBV is a herpesvirus that causes infectious mononucleosis and is associated with cancers like Burkitt's lymphoma and nasopharyngeal carcinoma. It infects B lymphocytes and epithelial cells, and can establish a latent infection in B cells. Primary infection often causes asymptomatic or mild illness, while reactivation can sometimes occur in immunosuppressed individuals. EBV is diagnosed through viral culture, serology to detect antibodies, or detecting viral DNA through molecular techniques. It is very common worldwide, though patterns of infection and disease manifestation vary between developed and developing areas.
EBV is a herpesvirus that causes infectious mononucleosis and is associated with cancers like Burkitt's lymphoma and nasopharyngeal carcinoma. It infects B lymphocytes and epithelial cells, and can establish a latent infection in B cells. Primary infection often causes asymptomatic or mild illness, while reactivation can sometimes occur in immunosuppressed individuals. EBV is diagnosed through viral culture, serology to detect antibodies, or detecting viral DNA through molecular techniques. It is very common worldwide, though patterns of infection and disease manifestation vary between developed and developing areas.
EBV is ubiquitous herpesvirus that is the Epstein-Barr virus (EBV) or
causative agent of acute infectious mononucleosis
(HHV-4) (IMN), nasopharyngeal carcinoma, Burkitt's lymphoma & other lymphoproliferative disorders in immunodeficient hosts. One target cell for EBV is the B lymphocytes where it persist in a latent state. Infection occur through binding to viral receptor (CD21). B lymphocytes infected by EBV become immortalized. Pathogenesis & pathology: EBV is commonly transmitted by infected saliva & initiate infection in the oropharynx. Viral replication occur in epithelial cells of the pharynx & salivary gland. EBV infected B lymphocytes synthesize immunoglobulin. MI is a polyclonal transformation of B cells. Autoantibodies are typical of the disease. Reactivation of EBV latent infection can occur but are usually asymptomatic. Immunosuppresion is a factor of reactivation infection. EBV is associated with the development of Burkitt's lymphoma (a tumor of the jaw in Epstein-Barr virus (EBV) or African children & young adults). > 90% of (HHV-4) African tumor contain viral DNA. In other parts of the world, 20% of Burkitt's lymphoma contain EB viral DNA. EBV may be involved in the early stage of BL by immortalizing B cells. Nasopharyngeal carcinoma is a cancer of epithelial cells is common in males of Chinese origin. EB viral DNA is regularly found in nasopharyngeal carcinoma cells. Immunodeficient hosts are susceptible to EBV induced lymphoproliferative diseases that maybe fatal. Lymphoproliferative disease is tend to develop following primary infection in patients suffering from either congenital or drug- induced immunodeficiency. AIDS patients are susceptible to severe EBV associated lesions; diffuse polyclonal lymphoma, lymphocytic interstitial pneumonitis & oral hairy leukoplakia of the tongue. Clinical findings: Most primary infections in children are Epstein-Barr virus (EBV) or asymptomatic. In older children & adults the (HHV-4) classical syndrome associated with primary infection is IMN (35-75% of the cases). The incubation period of IMN is 1-2 months, symptoms of headache, malaise, sore throat, fever , enlargement of LNs & spleen. The typical illness is self-limited lasts for 2-4 weeks. There leukocytosis with the predominance of lymphocytes (many of them are large & atypical). Oral hairy leukoplakia is a wort-like growth develop on the tongue of some HIV infected patients & transplant patients. EBV is recognized as the cause of Burkitt's lymphoma, nasopharyngeal carcinoma & Hodgkin's disease. EBV- associated B cell lymphomas are a complication for immunodeficient patients. Atypical lymphocytes Laboratory diagnosis: Epstein-Barr virus (EBV) or 1. isolation & identification of virus. (HHV-4) 2. Serology: The EBV genome encodes a number of different structural and nonstructural genes, those of most importance for serodiagnosis are encoding the viral capsid antigens (VCAs), the early antigens (EAs), and the EBNAs EBNA-1 and EBNA-2. the common serological procedure is ELISA. Early in acute disease, a rise in IgM to viral capsid antigen (VCA)replaced within weeks by IgG which persist for life. The presence of anti-VCA IgM suggestive of recent infection, while the presence of anti- VCA IgG indicate past infection & immunity. EBNA-1 IgG Ab, are produced late in the course of infection, while EBNA-2 IgG Ab appear earlier and may be present in up to 30% of individuals at the time of onset of the disease. EBNA-1 IgG Ab basically persist lifelong, but not in all individuals due to lost under circumstances e.g.immunosuppression. The use of anti-EBNA-1 versus anti-EBNA-2 Abs ratio for the serodiagnosis of EBV reactivation. Tests for anti-EBNA-2 Abs are not always available commercially. Anti-EA Abs of IgG and IgA types are detectable in early after primary infection and individuals with past infections. However, EA Abs are also detectable in clinically healthy individuals, Therefore, EA- specific serological parameters do not confirm any stage-specific diagnosis. 3.Specific heterophil agglutination test may be used for diagnosis of EB- IMN. 4. Molecular techniques for detection of viral DNA. Epidemiology: Epstein-Barr virus (EBV) or EBV is common in all parts of the world. In (HHV-4) developing areas infections occurs early in life (> 90% of children are infected by the age of 6 ys). Most of these infections are asymptomatic, however, it results in permanent immunity.
In developed areas > 50% 0f EBV infections are
delayed to older children & adults & 50% of these infections are manifested by IMN. Burkitt's lymphoma occur throughout the world, but Africa as high incidence. EB viral NA present in > 90% of African Burkitt's lymphoma, while in other parts o the world, the EB viral DNA present in 20% of BL. Nasopharyngeal carcinoma is a rare tumor of adults except in China where the incidence is high. EBV DNA present in NPC cells from different parts of the world.