Fulminant epsteinbarr virus infectious mononucleosis in. The epstein barr virus ebv is the most common herpesvirus in humans and the most common causative agent of infectious mononucleosis1. Pdf recent advances in understanding epsteinbarr virus. Epsteinbarr virus ebv, a member of the herpes group, infects many normal. In 1968, the virus was linked to the disease infectious mononucleosis glandular fever infection with epsteinbarr virus ebv is common and usually occurs in childhood or early adulthood. Latent epsteinbarr virus ebv infection contributes to both bcell and epithelialcell malignancies. Abstract epidemiological and serological evidence has suggested a role for epsteinbarr virus infection in the aetiology of multiple sclerosis. Epsteinbarr virus, a gamma herpes virus also known as human herpesvirus hhv4. Ebv has subsequently been found to be associated with a diverse range of tumours of. Ebv is transmitted from person to person and then infects human b cells, which in turn spread the infection throughout the entire reticuloendothelial system res, or the liver, spleen, and peripheral lymph nodes. Replication of epstein barr virus can occur in two ways. Antibody titers to epsteinbarr virus were determined in patients with.
Epstein barr virus is a human herpesvirus with striking biological properties. Epsteinbarr virus ebv is a ubiquitous herpes virus that infects most children during early childhood and causes few, if any, symptoms. Clinical characteristics of patients with epstein barr. The infection is most common in populations with many young adults, such as activeduty military personnel and college students, in whom the annual incidence. Answer although you should start feeling better in two to four weeks, the fatigue can stick around much longer. Ebv has been linked to a wide spectrum of human malignancies, including nasopharyngeal carcinoma and other hematologic cancers, like hodgkins lymphoma, burkitts lymphoma bl, bcell. The incidence of epsteinbarr virus primary infection among. It has been isolated from cells cultured from burkitts lymphoma and has been found in certain cases of nasopharyngeal carcinoma.
In addition, ebv is linked with oral hairy leukoplakia, which may be an earliest oral manifestation of hiv infection. Epsteinbarr virus infections definition of epsteinbarr. Thus, a comprehensive and uptodate analysis focused on the global burden of ebvattributable malignancies is of significant interest. In the developed world, 95% eventually infected by age 40, an estimated 3040% college freshman are uninfected. Epsteinbarr virus ebv infection occurs by distinct mechanisms across different cell types. Epsteinbarr virus ebv is a gammaherpes virus that widely infects human populations predominantly at an early age but remains mostly asymptomatic. The virus was first discovered in 1964 when sir michael anthony epstein and ms. T o m aintain the inte grity of the viral genom e and to get out of. Serological diagnosis of epstein barr virus l ross whybin seals serology epstein barr virus ebv family herpesviridiae, subfamily gammaherpesvirinae, genus lymphocryptovirus ds dna enveloped virus nucleocapsid 100110nm in diam. Antibodies to epsteinbarr virus in iridocorneal endothelial.
The viruss structure consists of an envelope, spikes, a core, a capsid and a tegument. Epstein and colleagues discovered the virus that now bears their names growing in cultured lymphoblasts derived from burkitts lymphoma biopsies. There are several forms of epsteinbarr virus ebv infection. A cancerassociated epsteinbarr virus bzlf1 promoter. Role of epstein barr virus infection in the development of autoimmune thyroid diseases andrea janegova et al.
Ebv infection of b cells generates a subset of cells that are actively producing infectious virus particles. Viral reactivation from latency is associated with an increased risk of ebvdriven cancers, and thus may be a target for disease prevention. When infection with ebv occurs during adolescence or young adulthood, it causes infectious mononucleosis 35% to 50% of the time. There may be an association between ebv and chronic fatigue syndrome. Infectious mononucleosis the kissing disease michaela weisser, university of.
Thus ebv igm antibodies indicate a recent ebv infection. A mean of 19 independent cell lines was made per patient, and in each case the resident virus was characterized by pcrbased viral genomic analysis and by. The most common manifestation of primary infection with this organism is acute infectious mononucleosis, a selflimited clinical syndrome. Some people with ebv will develop infectious mononucleosis or other illnesses, and will recover from their illness with no other problems. Ebv also epsteinbarr virus epsteinbarr, was formerly suspected as the cause of chronic fatigue. However, whether lytic ebv infection also contributes to tumors is. Epsteinbarr virus ebv is an oncogenic virus implicated in the pathogenesis of a number of human malignancies of both lymphoid and epithelial origin. Most people about 95% by adulthood become infected by ebv at some point of their lives and never have any health problems. Epsteinbarr virus infection as a cause of cervical. V with many of these complications remains based on scattered case reports, often using unsophisticated diagnostic tests, and the evidence for causation in many instances is unconvincing. In cases of individuals which undergo primary infection in the form of an infectious mononucleosis, or which have. It contains a linear doublestranded dna with approximately 170 x 10 3 base pairs and a guanosineplus cytosine content of 57%.
Chronic active epstein barr virus infection caebv is a very rare complication of an epstein barr virus ebv. Central nervous system cns complications of epsteinbarr virus ebv infection occur in 1 to 18% of patients with infectious. It is always important to remember to wash your hands and have good hygiene to help prevent the spread of infection. Latent epsteinbarr virus infection in cottontop tamarins. Infectious mononucleosis is a clinical syndrome most commonly associated with primary epsteinbarr virus infection. Infectious mononucleosis is the clinical manifestation of primary infection with epsteinbarr virus ebv. Ebv is found worldwide and is a common cause of viral pharyngitis, especially in young adults. In the oropharynx, ebv directly infects resting b cells or infects epithelial cells, which in turn infect b cells. Tenofovir prodrugs potently inhibit epsteinbarr virus. Infectious mononucleosis im and epstein barr virus 1. Epsteinbarr virus ebv, or human herpesvirus 4, is a gammaherpesvirus that infects more than 95% of the worlds population. Yvonne barr found it in a burkitt lymphoma cell line. Using electron microscopy, they found herpeslike particles in a number ofbiopsied cells establishing that this was in fact a new virus.
Ebv can cause infectious mononucleosis, also called mono, and other illnesses. Infectious mononucleosis im and epsteinbarr virus ebv for third year medical students dr. Epsteinbarr virus infections, including infectious. Ebv was thus identified as the first candidate tumor virus. All these structures aid in making the virus successful in the infection process and as a means of avoiding. Epsteinbarr virus ebv is a widely disseminated herpesvirus that is spread by intimate contact between susceptible persons and asymptomatic ebv shedders.
Epsteinbarr virus, frequently referred to as ebv, is a member of the herpesvirus family and one of the most common human viruses. However, ebv is involved in several types of lymphomas and a subset about 9% of gastric carcinomas, although its specific role in gastric carcinogenesis remains unclear. Review article medical progress columbia university. Epsteinbarr virus ebv, mono or mononucleosis infection. This type of herpes is very different from both herpes simplex and varicella zoster. Epsteinbarr virus latent membrane protein 1 induces. Biology of epsteinbarr virus during infectious mononucleosis. Because most people become infected with ebv at some point throughout their lifetime. The epsteinbarr virus ebv is a member of the herpes virus family human herpesvirus 4.
These include asymptomatic infections, the primary infection, infectious mononucleosis, and the progression of asymptomatic or primary infections to. Chronic active epsteinbarr virus infection genetic and. Ebv has been found in biopsy tissue of patients with hodgkins courtesy of nasa. It is also the first human cancer virus, having been recognized as the cause of endemic burkitt lymphoma in the 1960s. Epstein barr virus ebv igm antibodies can be demonstrated for only a few weeks after onset of infectious mononucleosis im. The hallmark of such infection is the appearance of atypical lymphocytes in the. Ebv is an acute infection with a characteristic symptomatic triad of fever, sore throat and lymphadenopathy. Epsteinbarr virus strain variation in nasopharyngeal. Epidemiology of infection with epsteinbarr virus types 1 and 2 ncbi. It is more than 50 years since the epsteinbarr virus ebv, the first human tumour virus, was discovered. By contrast, infection of epithelial cells requires a minimum of 3 viral glycoproteins, which are capable of interacting with one or more of 3 different cellular proteins.
Stat3 is constitutively activated in chronic active epsteinbarr virus. Epsteinbarr virus ebv, also known as human herpesvirus 4, is a member of the herpes virus family. The vast majority of the human adult population is infected with epsteinbarr virus ebv, and the majority of the ebvinfected individuals tolerates the infection well, without any further symptoms after primary infection. The epsteinbarr virus ebv is also known as human herpes virus 4 hhv4. Epsteinbarr virus ebv is a highly prevalent herpes virus that can cause transient infectious mononucleosis, ebvrelated malignancies, and chronic active ebv caebv infection. The epsteinbarr virus ebv, sometimes abbreviated as epv, formally called human gammaherpesvirus 4, is one of the nine known human herpesvirus types in the herpes family, and is one of the most common viruses in humans it is best known as the cause of infectious mononucleosis mono or glandular fever. It persists in a quiescent state in resting memory b lymphocytes for life in virtually every human being, yet it is also a potent transforming virus in vitro for b cells and is associated with several important lymphomas, specifically burkitts, hodgkins disease and immunoblastic lymphoma.
Epstein barr virus ebvassociated diseases represent a major cause of morbidity worldwide, accounting for at least 1. Like all herpesviruses, the epsteinbarr virus is relatively large and complex. Chronic active epsteinbarr virus infection caebv is a. In this report we present a rare case of esophageal rupture that has never been. In the patient population treated at the center, elevated ebv antibody titer is a common finding. Hussein mohammed jumaah cabm mosul medical college 32014 2. Primary infection with cmv in late childhood or adulthood is often associated with a vigorous t lymphocyte response that may contribute to the development of a mononucleosis syndrome similar to that which follows infection with epsteinbarr virus chap.
However, infectious mononucleosis may be associated with several acute complications. Epsteinbarr virus infects over 90% of the world population and is the causative agent of infectious mononucleosis. The epstein barr virus ebv is the first identif ied human virus with a proven association with the pathogenesis of can cer. Ebv share similar sequences and genetic organization, and they maintain persistent infection in the orophar ynx and. During this stage the virus is constantly being repilicated. Mohsen meidani ebv is also associated with several human tumors. Epsteinbarr virus ebv is an opportunistic human pathogen that. Mohsen meidani infectious mononucleosis including dr. Most people get infected with ebv at some point in their lives. The majority of patients with infectious mononucleosis recovers without apparent sequelae.
Pediatric mononucleosis and epsteinbarr virus infection. The pathogenesis of epsteinbarr virus persistent infection. Chronic active epsteinbarr virus infection caebv is a very rare complication of an epstein barr virus ebv. It is also associated with various nonmalignant, premalignant, and malignant. Acute complications of epsteinbarr virus infectious. Mohsen meidani epsteinbarr virus ebv is the cause of heterophilepositive infectious mononucleosis im, which is characterized by fever,sore throat, lymphadenopathy, and atypical lymphocytosis.
During a recent 33 day period, 32 patients seen at the center had serological evidence of current, recent or past infection with ebv table 1. Pdf epsteinbarr virus ebv is a common human herpes virus known to infect the majority of the world population. A possible model for epsteinbarr virus infection in humans. In addition to burkitt lymphoma, ebv is implicated in the pathogenesis of hodgkin lymphoma, nasopharyngeal carcinoma, gastric. The epsteinbarr virus ebv, also called human herpesvirus 4 hhv4, is a virus of the herpes family which includes herpes simplex virus and cytomegalovirus, and is one of the most common. Maruo s, yang l, takada k 2001 roles of epstein barr virus glycoproteins gp350 and gp25 in the infection of human epithelial cells.
Infectious mononucleosis caused by epsteinbarr virus ebv. Because it has mononuclear lymphocytosis with atypical. Since then, ebv has also been associated with nasopharyngeal carcinoma, which is highly prevalent in southeast asia, as well as infectious mononucleosis, complications of aids. Ebv mostly spread by asymptomatic salivary shedding. Barr virus ebv was first reported as the etiological agent of burkitts lymphoma in 1964. In developing countries, subclinical infection in childhood is virtually universal. An external file that holds a picture, illustration, etc. Infection is more prevalent and occurs at an earlier age in lower socioeconomic groups. Although ebvinfected t or nk cells in caebv clonally proliferate, they usually do not form solid tumors 8, 9. Pdf the role of epsteinbarr virus infection in the.
Antiebv agents that are safe, effective, and suitable for. Epstein barr virus an overview sciencedirect topics. Molecular detection of epstein barr virus in nasopharyngeal. Get a printable copy pdf file of the complete article 3. Rather than remaining dormant in the nerve cells after infection, ebv resides in b lymphocytes, a type immune system cell. Ebv spreads most commonly through bodily fluids, primarily saliva. Corticosteroids may have a role in hastening resolution of some complications, especially upper. Many children become infected with epsteinbarr virus ebv. Ebv infection of b cells in vitro minimally requires 5 viral glycoproteins and 2 cellular proteins. Pdf epsteinbarr virus and associated head and neck. The most common manifestation of primary infection with this organism is acute infectious mononucleosis, a selflimited clinical syndrome that most frequently affects adolescents and young adults.
Since the 1800s, infectious mononucleosis has been recognized as a clinical syndrome consisting of fever, pharyngitis, and adenopathy. During primary infection, ebvinfected b cells undergo lytic infection with production of virus or express the full complement of latent viral proteins. Based on published studies, we estimated the proportion of burkitts lymphoma bl, hodgkins lymphoma. Caebv infection is a persistent ebv infection in combination with infectious mononucleosislike symptoms in individuals without apparent immunodeficiency. There is little benefit of antiviral treatment of uncomplicated or complicated infectious mononucleosis. How long does it take to recover from an epsteinbarr virus infection. Space flightinduced reactivation of latent disease, breast cancer, and some smooth muscle tumors. Epsteinbarr virus ebv is arguably the most ubiquitous of human viruses, infecting at least 90% of adults worldwide. Reactivation of latent ebv is clinically significant in immunocompromised patients and as a rule accompanies lymphoproliferative disease. How long does it take to recover from an epsteinbarr. Whether you call it mono, hhv4, epsteinbarr virus, glandular fever, ebv, human herpesvirus 4, the kissing disease or infectious mononucleosis, the viral infection can have varied types of pathology.
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