EBV

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    • EBV
      • causative agent of Infectious Mononucleosis in young adults (MCQ)
      • associated with the childhood disease Burkitt lymphoma (BL)
      • Most transmission occurs by saliva (MCQ)
      • The initial site of virus replication is  oropharyngeal epithelium
      • The B-cell receptor for EBV is the complement component C3b receptor.. (MCQ)
      • EBV infection of B cells causes the induction of a number of cellular lymphokines, including B-cell growth factors.
      • In contrast to other herpes viruses, the early genes of EBV induce cell multiplication and immortalization, rather than cell death.
      • EBV infection induces a polyclonal B- cell proliferation
      • Causes nonspecific increase in total IgM, IgG, and IgA.
      • The IgM class contains heterophile antibodies that agglutinate sheep and horse red blood cells. (MCQ)
        • heterophile antibodies are the basis for the classic diagnostic test for EBV-associated IM (MCQ)
      • EBV is associated with a small number of T-cell malignancies. in patients who are immunodeficient or immunosuppressed
      • Infectious mononucleosis
        • typical IM syndrome appears after an incubation period of 4 to 7 weeks (MCQ)
        • includes pharyngitis, lymphadenopathy, fever, splenomegaly, and  EBV and malignancies
      • Burkitt lymphoma:
        • BL cells contain chromosome translocations
        • The breakpoints of these translocations are such that the c- myc proto-oncogene on chromosome 8 is constitutively activated. (MCQ)
        • Malarial infection and HIV infection are known risk factors for development of BL.
      • Epstein-Barr–associated nasopharyngeal carcinoma (MCQ)
      • Epstein-Barr virus infections in immunocompromised and immunosuppressed patients:
        • EBV induces B-cell lymphomas in immunocompromised patients
          • BL of the sporadic type occurs with high frequency in earlier stages of AIDS progression (MCQ)
          • non–BL-type lymphoblastic lymphomas are more characteristic in late-stage AIDS patients (MCQ)
        • AIDS patients infected with EBV may exhibit nonmalignant, white-gray lesions on the tongue (“hairy leuko- plakia”) (MCQ)
      • Laboratory identification
        • Atypical lymphocytes (cytotoxic T cells) can be observed in the blood smear of a patient with IM (MCQ)
        • The Paul-Bunnell test, (MCQ)
          • the classic test for IM (MCQ)
          • based upon the nonspecific elevation of all Igs, including heterophile antibodies that specifically agglutinate horse and sheep red blood cells, (MCQ)
          • polyclonal stimulation of B cells by EBV infection occurs
          • These heterophile antibodies are diagnostic for EBV-related IM (MCQ)
          • they are not present in all cases of EBV IM
        • IgM and IgG antibodies specific for EBNA1 and capsid proteins can be detected by serological techniques.
      • Treatment
        • None of the antiherpes drugs have been effective in modifying the course or severity of IM due to EBV or in preventing development of EBV-related B-cell malignancies.
        • Acyclovir has been successful in treating oral hairy leukoplakia (MCQ)


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