Epstein-Barr Virus Infections: Biology, Pathogenesis, and Management

  title={Epstein-Barr Virus Infections: Biology, Pathogenesis, and Management},
  author={Stephen E. Straus and JE Cohen and Giovanna Tosato and Jeffery L Meier},
  journal={Annals of Internal Medicine},
Dr. Stephen E. Straus (Medical Virology Section, Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases [NIAID], National Institutes of Health [NIH], Bethesda, Maryland): Epstein-Barr virus (EBV) is a ubiquitous pathogen that has evolved an effective strategy for infection, persistence, and spread; EBV infection occurs in more than 90% of the population, most often without evident consequences [1, 2]. The clinical outcome of infection rests on the compromise… 
Epstein-Barr virus infections of the nervous system.
  • A. Tselis
  • Medicine
    Handbook of clinical neurology
  • 2014
Epstein-Barr virus-recent advances.
The pathogenesis of primary, latent and reactivated Epstein–Barr virus infections: an update on clinically relevant interactions between Epstein–Barr virus and the human immune response
This review summarizes the main interactions between EBV and the innate and cellular immune responses, and the findings of key recent research, with reference to the pathogenesis of EBV-associated clinical syndromes.
Epstein-Barr Virus Infection and Posttransplant Lymphoproliferative Disease
The most significant EBV-associated illness that occurs following solid-organ or hematopoietic stem cell transplantation is posttransplant lymphoproliferative disease (PTLD).
Pathogenesis of chronic active Epstein‐Barr virus infection: Is this an infectious disease, lymphoproliferative disorder, or immunodeficiency?
  • H. Kimura
  • Biology, Medicine
    Reviews in medical virology
  • 2006
The current understanding of the pathogenesis of CAEBV is summarized and a model ofCAEBV pathogenicity is proposed, which suggests a defect or single nucleotide polymorphism in host immune‐modulating genes may allow for the expansion of virus infected cells giving rise to CA EBV.
Acute infectious mononucleosis and coincidental measles virus infection.
EBV Chronic Infections
The mechanisms of EBV latency have been carefully examined both because they represent the virus strategy to elude the response of the immune system of the host, and because they are correlated with those oncologic conditions associated to the viral persistence, particularly lymphomas and lymphoproliferative disorders.
Successful treatment of Epstein–Barr virus infection associated with myocarditis
There is a general reluctance to use steroids routinely in the treatment of EBV infection, because of unknown long-term effects on the natural immunity to EBV and the possible complications of encephalitis and myocarditis.
A spectrum of clinical manifestations caused by host immune responses against Epstein-Barr virus infections.
The oncogenic role of latent EBV infection is not yet fully understood, but latent membrane proteins expressed during the latency cycle have essential biological properties leading to cellular gene expression and immortalization, andEBV-encoded gene products such as viral interleukin-10 (vIL-10) and bcl-2 homologue function to survive the EBV-infected cells.
Diagnosis of Epstein-Barr virus-associated diseases.
  • S. Tsuchiya
  • Medicine, Biology
    Critical reviews in oncology/hematology
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Epstein-Barr virus and human diseases: recent advances in diagnosis
The early accurate diagnosis of EBV infection can be achieved by performing EBV-specific serology, detecting forEBV-determined nuclear antigen in tissues, establishing spontaneous lymphoid cell lines, and using molecular hybridization techniques for demonstrating the presence of viral genome in affected lesions.
The Epstein-Barr virus and the immune system.
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    Advances in cancer research
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Epstein-Barr virus antibody in cases and contacts of infectious mononucleosis; a family study
Serological investigations on 147 patients with Paul—Bunnell positive infectious mononucleosis from the general population found EBY antibody prevalence among patients' siblings was significantly lower than among age-matched controls, suggesting that cases of IM come from families with a lower than normal previous experience of the virus.
Chronic Epstein-Barr virus infection associated with fever and interstitial pneumonitis. Clinical and serologic features and response to antiviral chemotherapy.
Two patients developed fever, interstitial pneumonitis, and pancytopenia associated with extremely high titers of antibody to replicative antigens of the Epstein-Barr virus and provide additional evidence that acyclovir may play a role in therapy for selected patients with Epstein-barr virus infection.
Epstein-Barr virus infections in males with the X-linked lymphoproliferative syndrome.
It is hypothesized that the defective lymphoproliferative control locus on the X chromosome results in unregulated cytotoxic lymphocytic responses to the Epstein-Barr virus; hence, severe hepatitis and virus-associated hemophagocytic syndrome occur with the infectious mononucleosis phenotype.
Management of Epstein-Barr virus infections.
Both oral and intravenous acyclovir administration for seven days in the early stages of infectious mononucleosis caused an inhibition of oropharyngeal Epstein-Barr virus (EBV) replication, and development of normal cellular and humoral EBV-specific immunity was seen in all patients.
T-cell lymphomas containing Epstein-Barr viral DNA in patients with chronic Epstein-Barr virus infections.
It is concluded that EBV may infect T cells and contribute to lymphomas in selected patients with severe EBV infections.
Immunohistology of Epstein-Barr virus-associated antigens in B cell disorders from immunocompromised individuals.
Proliferating B cell lesions developing in a series of immunosuppressed organ transplant recipients and patients with X-linked lymphoproliferative syndrome were examined for Epstein-Barr virus and cellular gene expression using immunocytochemistry and immunoblotting techniques, and results indicate that all the lesions examined were consistent with a latent, nonproductive type of infection.
Eradication of Epstein-Barr virus by allogeneic bone marrow transplantation: implications for sites of viral latency.
Results suggest that the latently EBV-infected host cells reside in a cellular compartment that can be destroyed by graft-versus-host reactivity, irradiation, or cytotoxic drugs, and Hemopoietic tissue is the most likely candidate.