Epstein Barr Virus

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Contents 1 Epidemiology 2 Pathology 3 Genetics 4 Laboratory 5 Management 6 More General Terms 7 Additional Terms 8 References

Epidemiology

• humans are the sole source of the virus
• may be isolated from genital & oral secretions
• 67% of college men & 79% of college women are seropositive
• oral & genital transmission
• transmission occurs most commonly through prolonged & repeated contact with infected saliva & rarely through blood transfusions or bone-marrow transplantation

Pathology

• EBV infects epithelial cells of the oropharynx, cervix & resting B lymphocytes which disseminate & proliferate until checked by activated T-cells
• putative receptor: CD21
• EBV is associated with:

• infectious mononucleosis
• Burkitt's lymphoma
• Gianotto-Crosti syndrome
• B-cell lymphoma in immunocompromised hosts
• oral hairy leukoplakia
• nasopharyngeal carcinoma
• aseptic meningitis, encephalitis
• febrile neutropenia
• hepatitis
• hemolytic anemia
• thrombocytopenia [4]

Genetics

• double-stranded DNA virus of the Herpes virus family
• human proteins implicated in EBV infection:

• CCR7, GPR183

• EBV induces ZNF271

Laboratory

• heterophile antibody test ( Monospot test)
• EBV serology, if heterophile antibody negative

• acute primary infection

• elevated EBV viral capsid antigen IgM & EBV viral capsid antigen IgG
• elevated EBV early antigen IgG
• low or undetectable IgG against EBV nuclear antigen

• past infection

• undectable IgM against viral capsid antigen
• elevated IgG against viral capsid antigen
• undectable IgG against EBV early antigen
• elevated IgG against EBV nuclear antigen

• PCR/southern blot/in-situ hybridization

Management

• see infectious mononucleosis

More General Terms

• herpesviridae
• oncogenic virus

Additional Terms

• B-cell lymphoid neoplasm (B-cell lymphoma)
• Burkitt's lymphoma
• CC chemokine receptor type 7; C-C CKR-7; CC-CKR-7; CCR-7; MIP-3 beta receptor; EBV-induced G-protein coupled receptor 1; EBI1; BLR2; CDw197; CD197 (CCR7, CMKBR7, EBI1, EVI1)
• G-protein coupled receptor 183; EBV-induced G-protein coupled receptor 2 (GPR183, EBI2)
• Gianotti-Crosti syndrome (papular acrodermatitis of childhood)
• hairy leukoplakia
• heterophile antibody (Monospot)
• infectious mononucleosis
• PCR/southern blot/in-situ hybridization for Epstein-Barr virus

References

1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 872-73
2. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 769
3. Journal Watch 22(21):157, 2002 Crawford DH et al Sexual history and Epstein-Barr virus infection. J Infect Dis 2002, 186:731 PMID: [1]
4. Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006

Epstein-Barr virus (EBV); human herpesvirus 4