Epstein-Barr Virus

(EBV)

• gamma-herpesvirus

• causes B-cell lymphomas

  • e.g. Burkitt's lymphoma

• causes heterophile antibody-positive infectious mononucleosis (glandular fever)

• transmitted in saliva

• infects oropharynx epithelium

• infects B-cells

  • immortalises

  • increases in size

  • killed by T-cells

• small portion remains latent in B-cells

• periodically reactivated and shed in saliva

• patient under 10 do not get symptoms

• rash is common after ampicillin given

Laboratory tests

• Viral capsid antigen (VCA) IgM / IgG

  • markers of acute / chronic infection

• Epstein-Barr Nuclear antigen (EBNA) IgG

  • should not be present with EBV VCA IgM

• Paul-Bunnell test

  • antibodies against sheep erythrocytes produced that cross-react with an acute EBV infection

  • false positives

    • viral Hepatitis

    • Hodgkin's Disease

    • Acute Leukaemia

• Acute Hepatitis A serology will cross-react with EBV

Complications

• Burkitts lymphoma

• lymphoproliferative disorders

  • if patient iatrogenically immunosuppressed then withdrawing immunosuppression can be treatment of disorder

• nasopharyngeal carcinoma

• oral hairy leukoplakia in AIDS patients

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