ABSTRACT
Non-hepatotropic viruses such as Epstein-Barr virus(EBV) has high infection rate in the population with biological characteristics of infective-latent-activation. EBV-related diseases including infectious mononucleosis(IM), chronic active EBV infection(CAEBV), EBV-related tumors and other diseases are complex and diverse, and all these can lead to varying degrees of liver damage.CAEBV can induce hepatitis(chronic active Epstein-Barr virus hepatitis, CAEBVH) or even liver failure. The prognosis of the disease is poor and the mortality rate is high. Early identification, diagnosis, and multidisciplinary collaborative treatment of CAEBVH are key to improving the prognosis of patients. This article will review the diagnosis and treatment progress of CAEBVH, and provide references for clinicians to diagnose and treat CAEBVH.
ABSTRACT
Chronic active EBV (CAEBV) infection presents with persistent or recurring IM-like symptoms including fever, hepatosplenomegaly, lymphadenopathy, and liver dysfunction without definite underlying diseases at the diagnosis. No causative pathogenetic mechanisms have been sufficiently clarified, these patients have high EBV-DNA load in the peripheral blood and systemic clonal expansion of EBV-infected T cells, NK cells and B cells. Their prognosis is poor with life-threatening complications including hemophagocytic lymphohistiocytosis, diverse organ failure, malignant lymphomas and so on. Allogeneic hematopoietic stem cell transplantation(Allo-HSCT)is the only effective therapy at present. This review outlines the recent progress of CAEBV clinical and fundamental research at home and abroad.
ABSTRACT
Objective To analyze the incidence of Epstein-Barr virus (EBV) infection in patients after allogeneic hematopoietic stem cell transplantation (HSCT),and investigate its risk factors and prognosis.Methods A total of 402 patients receiving HSCT were retrospectively studied from November 2011 to November 2014 in the 307th Hospital of Chinese People's Liberation Army.The cumulative incidence (CI) of EBV infection and survival rate were analyzed by Kaplan-Meier method,while risk factors were assessed by logistic regression model.Results The one-year CI of EBV viremia and post-transplant lymphoproliferative disease (PTLD) were 42.0％ and 1.5％,respectively.Using antithymocyte globulin (ATG) (P ＜ 0.001,OR =9.92) and acute graft-versus-host disease (GVHD) grade Ⅲ to Ⅳ (P ＜ 0.01,OR =2.42) were related risk factors of EBV viremia.There was a higher CI of EBV viremia in patients with 2 risk factors compared with those without (87.5％ vs 24.6％,P ＜0.001).Patients with EBV viremia had significant shorter three-year overall survival than patients without (58.5％ vs 75.4％,P ＜ 0.001).Conclusions The incidence of EBV infection in patients undergoing HSCT is high,which poses a threat on prognosis.Risk factors of EBV viremia include administration of ATG and severe acute GVHD.
ABSTRACT
The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.
Subject(s)
Adolescent , Child , Humans , Male , Abdominal Pain , Acyclovir , Ambulatory Care Facilities , B-Lymphocytes , Biopsy , Bronchoalveolar Lavage , Burkitt Lymphoma , Cyclophosphamide , Diagnosis , Doxorubicin , Drug Therapy, Combination , Epstein-Barr Virus Infections , Herpesvirus 4, Human , In Situ Hybridization , Lip , Lung , Lung Diseases, Interstitial , Lymphoproliferative Disorders , Methotrexate , Phenotype , Physical Examination , Pneumonia , Prednisolone , VincristineABSTRACT
Infectious mononucleosis caused by primary infection of Epstein-Barr virus (EBV) is a self-limiting lymphoproliferative disease, and shows concomitant clinical features such as pyrexia, anorexia, sore throat, cervical lymphadenopathy, liver dysfunction and hepatosplenomegaly. In rare cases, EBV establishes a latent infection in B lymphocytes and runs a chronic course and shows infectious mononucleosis-like symptoms repeatedly. This syndrome, named chronic active EBV infection, may trigger an autoimmune disease that mainly affectes the liver and red blood cells, and carries a very poor prognosis. The cardiovascular complications of chronic active EBV infection are very rare and may be associated with coronary arterial disease. This case describes a 5-year-old boy, who developed chronic active EBV infection and was diagnosed as having autoimmune hepatitis with a coronary aneurysm.
Subject(s)
Child, Preschool , Humans , Male , Anorexia , Autoimmune Diseases , B-Lymphocytes , Coronary Aneurysm , Epstein-Barr Virus Infections , Erythrocytes , Fever , Hepatitis , Hepatitis, Autoimmune , Herpesvirus 4, Human , Infectious Mononucleosis , Liver , Liver Diseases , Lymphatic Diseases , Pharyngitis , PrognosisABSTRACT
Objective To study on the attributive Zang-Fu of TCM to the EBV infection according to the malignant tumor. Methods The malignant tumor in-patients were reviewed to survey the EBV infection, and the nasopharyngeal carcinoma infected the EBV were reviewed to survey the transfer cancer occurance. Results Of the malignant tumor in-patients, there were high EBV infection appearances in the nasopharyngeal (87.5%), the liver (15.0%) the lung (8.3%). There was no EBV infection in the other malignant tumor in-patients. The transfer cancer of the nasopharyngeal carcinoma occurred in the liver (40%) and lung(25%). Conclusion The attributive Zang-Fu of TCM to the EBV infection are liver and lung.
ABSTRACT
Recenly,the incidence of posttransplatation lymphoproliferative disorder(PTLD) is rising,Immunodeficiency and EBV-infection are risk factors of pathogenesis related. The majority of PTLD originates from malignant proliferation of B-cell.Typical pathologic findings of PTLD are large number of plasmacytoid B cells in lymphotic tissue and often with necrosis in regional areas. Molecular biology findings are ras or p53 gene mutation and c-myc?bcl-6 gene rearrangement. Highly immunosuppressed patients may present with diffuse infiltration and functional failure of multiple organs,the prognosis is poor. Except for the decrease or discontinuation of the immunosuppressive therapy,antiviral agents and interferon- ?,anti B-cell monoclonal antibodies,autologous EBV-specific cytotoxic T cell and combination chemotherapy may achieve better responses.
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Objective To investigate the influence of EBV infection on the expression of tumor suppressor gene p53. Methods EBER1 in 217 cases of gastric carcinoma were detected with in situ hybridization. Then, EBV positive and negative cases were selected for analysis of the expression of p53 by immunohistochemistry. Results In 217 cases of gastric carcinoma, there were 23 cases with EBER1 positive. The average area (AA), mean absorbency and integral absorbency of p53 expression were higher in EBV positive gastric carcinoma than those in EBV negative. Conclusions EBV infection of gastric carcinoma is closely related to the expression of p53 in this study.
ABSTRACT
Familial hemophagocytic lymphohistiocytosis (FHL) is a rapidly fatal illness, usually encountered in infancy, characterized by fever, hepatosplenomegaly, pancytopenia, and central nervous system involvement. Microscopic examination of tissue shows a non-malignant lymphohistiocytic infiltrate, with prominent erythrophagocytosis. FHL is an autosomal recessive hereditary disorder but may develop secondarily to other conditions such as immunosuppression, malignancies, fat overload and certain infections. We recently experienced a case of siblings developing FHL, which may be associated with EBV infection.