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The urgency of Epstein-Barr virus infection is explained by wide circulation of Epstein-Barr virus among children and adults, its tropism to immunocompetent cells with lifelong persistence after primary infection and polymorphism of clinical manifestations from subclinical forms, infectious mononucleosis to formation of oncological, autoimmune hematological diseases.Persistence of Epstein - Barr virus Leads to suppression of cellular immunity, decreased production of interferons and nonspecific protection factors, which contributes to reactivation of persistent infection, most often without mononucleosis-like syndrome, and the appearance of atypical mononuclears in blood with the formation of lymphoproliferative, intoxication, astheno-vegetative syndrome, long-term subfebrile condition, which dictates the need for immunocorrective therapy. This article presents a clinical case describing and analyzing the course of a chronic Epstein-Barr virus infection in a preschool child (5 years 8 months) with a pre-morbid background. Episodes of reactivation of chronic persistent infection occurred under the mask of acute respiratory infection with lymphoproliferative syndrome, purulent tonsillitis, purulent adenoiditis. Therapy, including antibiotics, short-course antiviral agents, bacterial lysates, and physiotherapy, had a temporary and short-lived effect. meglumine acridonacetate. The described clinical case demonstrates the effectiveness of the inclusion of meglumine acridonacetate, which has antiviral, immunomodulatory and anti-inflammatory effects, in the complex treatment of Epstein-Barr virus infection, This allowed to obtain fairly rapid positive clinical dynamics of relieving intoxication and febrile and lymphoproliferative syndromes in the acute period, and subsequently - astheno-vegetative syndrome and achieve the transition of active chronic Epstein - Barr virus infection into a latent form.

RESUMEN El Linfoma de Células Grandes B difuso asociado al virus Epstein Barr no especificado es una entidad frecuente en Sudamérica, que afecta a pacientes de todas las edades, pero con mayor frecuencia a pacientes seniles. El diagnóstico es a través de la identificación del Epstein Barr virus dentro de la célula tumoral mediante la prueba EBER. El pronóstico es desfavorable a pesar de haber mejorado con la introducción del rituximab. Se cuentan con nuevos scores pronósticos para la identificación de subgrupos de riesgo. El tratamiento continúa siendo el mismo que para los casos de Linfoma de Células Grandes B difuso, virus Epstein Barr negativo. Se esperan nuevas estrategias terapéuticas novedosas frente a esta entidad. ABSTRACT Diffuse Large B-Cell Lymphoma associated with Epstein Barr virus Not otherwise specified is a frequent entity in South America, which affects patients of all ages but more frequently senile patients. Diagnosis is through the identification of the Epstein Barr virus within the tumor cell using the EBER test. The prognosis is unfavorable despite having improved with the introduction of rituximab. There are new prognostic scores for the identification of risk subgroups. The treatment continues to be the same as for cases of Epstein Barr virus-negative diffuse Large B-Cell Lymphoma. New novel therapeutic strategies against this entity are expected.

Aim of study. To assess the humoral and cytokine status in children with infectious mononucleosis (induced by Epstein-Barr virus), recurrent respiratory infections and adenoviral infection. Material and methods. Indices of humoral (IgА, IgМ and IgG immunoglobulins) and cytokine (IFN-α and IFN-γ interferons, IL-1β and IL-6 interleukins) immunity were evaluated in 93 children with infectious mononucleosis (induced by Epstein-Barr virus (EBV)), 167 children with recurrent respiratory infections of the upper respiratory tract (RRI) and 76 children with adenoviral infection (AI) aged 1 to 18 years as well as 90 children of the same age without diseases associated with lymphoproliferative syndrome and with no medical illnesses exacerbating at the moment of study. Results. A decrease in virus resistance of children with viral infections combined with the lymphoproliferative syndrome was manifested by a 1.5 to 2-fold decrease of IFN-α and IFN-γ. Signifi cantly elevated levels of IL-1β and IL-6 anti-infl ammatory interleukins in children with viral infections combined with the lymphoproliferative syndrome attested to severe progression of the pathological process, predominantly in infectious mononucleosis (induced by EpsteinBarr virus). Results of analysis of cytokines in peripheral blood during infectious diseases may be considered as additional laboratory criteria for differential diagnosis of diseases accompanied by the lymphoproliferative syndrome. Conclusion. While interferons suppress viral replication, investigation of the cytokine status of children with infectious mononucleosis (induced by EpsteinBarr virus), recurrent respiratory infections and adenoviral infection is especially relevant for practical healthcare.

ANALYSIS OF THE CORRELATION BETWEEN ADVANCED GLYCATION END-PRODUCTS LEVELS AND THE CYTOKINE PROFILE IN PATIENTS WITH ALLERGIC DISEASES ASSOCIATED WITH CHRONIC EPSTEIN-BARR VIRAL INFECTION S. O. Zubchenko Danylo Halytsky Lviv National Medical University, Lviv, Ukraine Abstract. Advanced glycation end-products (AGEs) serve as densitometric markers of oxidative stress and inflammatory processes in many diseases and their complications. Objective: analysis of the correlation between AGEs and the cytokine profile in patients with allergic diseases associated with chronic Epstein-Barr viral infection (EBV-infection) in the active and latent phases. Object and methods. Determination and comparative analysis of AGEs levels and cytokines IL-17, IL-33, TNF-α in 66 patients aged (32.4 ± 7.5) years with allergic diseases associated with chronic EBV-infection in the active and latent phases and in EBV-seronegative patients with allergic diseases. Results. When determining AGEs by fluorescence spectroscopy in three groups of patients with allergic diseases, there was a reliably smaller number of AGEs than in healthy individuals. Presumably 12.3 % higher levels of IL-33 (p = 0.041) was determined in patients with active phase of EBV-infection compared to EBV-seronegative individuals, and in patients with latent phase of EBV-infection, the level of IL-17 was 3.54 times higher compared with EBVseronegative individuals (p = 0.011). It was determined that there is a reliable (p = 0.049) weak negative (r = -0.364) correlation between AGEs level and IL-33 in patients with allergic diseases associated with chronic EBV-infection in the active phase. It was investigated that no statistical difference between the levels of the proinflammatory cytokine TNF-α in the three groups was found. In patients with allergic diseases associated with chronic EBV-infection in the latent phase, a reliable (p = 0,032) weak negative (r = -0,364) correlation between AGEs and IL-17 was determined. Conclusions. Patients with allergic diseases compared to healthy individuals have lower levels of AGEs. AGEs play a significant pathogenetic role in the induction of allergic inflammatory process. AGEs accompanied by increased synthesis of IL-33 and IL-17 was more pronounced in patients with active phase EBV-infection, which was confirmed by clinical data. Key words: аdvanced glycation end-products, allergic diseases, chronic Epstein-Barr viral infection, cytokines. S. Zubchenko PhD, Associate Professor, Department of Clinical Immunology and Allergology Danylo Halytskyi Lviv National Medical University Pekarska street, 69, Lviv, Ukraine, 79010. Svitlanazu@gmail.com Аsthma and Allergy, 2021, 3, P. 30–35.

Dental caries and its complications remain one of the current problems of pediatric dentistry. Important in its development is a complex of local and general factors that contribute to the insufficient enamel mineralization, which creates conditions for the occurrence of dental caries, that is, caries favorable enamel is formed. Viral infection, which is nowadays extremely common in both adults and children, is one of the important risk factors for dental pathology, as it can lead to a reduction in nonspecific resistance and depletion of the body's defense mechanisms.Objective. Assessment of caries incidence of deciduous teeth in children with Epstein-Barr viral infection.Material and methods. To assess the state of dental hard tissues, 133 children aged 6-9 years (48 children with infectious mononucleosis and 85 practically healthy children) were examined. The prevalence and intensity of decay teeth caries, as well as caries activity were studied.Results. It was found that the prevalence and intensity of temporary tooth decay is significantly higher in children with Epstein-Barr viral infection than in children without evidence of viral infection. The proportion of incisors and canines affected by caries averaged 10.33 ± 1.08% with 89.64 ± 2.76% of temporal molar lesions. And the degree of activity of dental caries revealed in 20,94 ± 2,58% of children with infectious mononucleosis, the II degree of activity - in 50,22 ± 3,24%, the III degree of activity - in 21,23 ± 1,45%, this is true higher than in virtually healthy children (p

Background: Actuality of study of infectious mononucleosis (ІМ) is conditioned by high infected of population by the Epstein – Barr virus (EBV), specific virus affinity to the immunocompetent cells, lifelong virus persistence in an organism and often latent process. Methods: Research on the work topic was conducted at the Department of Infectious Diseases of Kharkiv National Medical University. A total of 45 patients with IM (26 men and 19 women) who were hospitalized at the Regional Clinical Hospital in 2018–2019 years were surveyed. The vast majority of patients with IM were young people aged from 18 to 25, of whom 597 % were students. Results: The clinical picture of infectious mononucleosis caused by the Epstein–Barr virus, mainly characterized by manifestations of hepatomegaly, lymphadenopathy, intoxication syndrome and nasopharyngeal tonsillitis. The efficacy of combined use of Valacyclovir and Nuclex in complex therapy of patients with infectious mononucleosis caused by Epstein – Barr virus (EBV) was studied. The use of such therapy was found to promotes regression of clinical symptoms, contribute to normalization of indices of clinical blood tests and lead to a decrease of the number of EVB's DNA copies in the blood serum or complete elimination of virus. Conclusions: Thus, evaluation of the effectiveness of the use of valacyclovir and nuclex in the complex therapy of patients with infectious mononucleosis caused by Epstein–Barr virus, indicates a more significant regression of clinical symptoms, significantly more pronounced positive impact on the indicators of clinical blood analysis and the number of copies of EBV DNA in blood serum than in the comparison group. Obtained results allowed to substantiate the use of complex therapy of valacyclovir and nuclex in patients with IM caused by EBV.

Today, about 85-95 % of the population is infected with EBV, therefore, the study of the nature of clinical and laboratory changes in patients with chronic EBV infection and the characteristics of the disease is an urgent problem of our time. According to the results of the study, it was found that in patients with chronic EBV infection, chronic tonsillitis, chronic fatigue syndrome and peripheral lymphadenopathy were more often observed among the clinical manifestations. In laboratory studies, it was found that patients with chronic EBV infection are characterized by a significant increase in ESR, an increase in the relative content of lymphocytes and monocytes, as well as a decrease in the absolute and relative content of neutrophils compared with the control group of patients, which indicates the presence of a shift in the leukocyte blood count, characteristic of the disease of viral etiology associated with EBV.

Аim. To study the severity of chronic erosive gastritis associated with Helicobacter pylori and Epstein-Barr virus depending on the number of copies of Epstein-Barr virus in biopsies of gastric mucosa. Materials and methods. The severity of chronic erosive gastritis associated with Helicobacter pylori in the presence and absence of Epstein-Barr virus in the gastric mucosa was compared in 65 patients, divided into 4 groups depending on the detection of Epstein-Barr virus in the gastric mucosa. Result. the presence of Epstein-Barr virus in the gastric mucosa aggravates the course of chronic erosive gastritis associated with Helicobacter pylori.

Oral Squamous Cell Carcinoma (OSCC) has varied etiology. Among the etiological factors, genetic predisposition or the presence of oncogenic viruses can cause impairment in the physiological mechanisms of cellular proliferation control. The present study was chosen to determine the association of Epstein- Barr virus (EBV) with oral squamous cell carcinoma and oral potentially malignant disorders (OPMD). Oral exfoliated cells were collected from the subjects diagnosed with OSCC (n = 19), OPMD (n = 23) and healthy subjects without any deleterious condition (n = 39). The DNA extraction was performed with DNeasy Blood & Tissue Kits (Qiagen, Germany). Quantitative Real-Time PCR was then carried out with QuantiNova® SYBR® Green PCR Kit (Qiagen, Germany). Statistical analysis was performed using Chi-square test. EBV DNA was detected in all samples of all the three groups. Compared to healthy subjects, very high EBV load was observed in the oral exfoliated cells of OSCC and OPMD patients. The presence of EBV DNA in all the subjects of all the three groups reveals that EBV is an oral resident. Besides its presence, the abundance of EBV DNA among OSCC and OPMD suggests it's association to these pathologies. The high odds and risk ratio obtained for EBV copy number further supports a strong association of this virus to OSCC and OPMD. This may be the first study to quantify EBV DNA in oral exfoliated epithelial cells of OSCC and OPMD.

El virus Epstein Barr (VEB) es un patógeno ubicuo que ha infectado y permanece en más del 90% de la población adulta, en partículas infecciosas en células de tejidos, el virus establece una infección latente de por vida, es uno de los virus más comunes en los seres humanos, además se ha relacionado con una gran cantidad de enfermedades, entre la que destacan ciertos tumores y cáncer de diferentes tipos. El objetivo de la investigación fue analizar la prevalencia y las bases científicas de la inmunopatogénesis de la infección por el virus Epstein Barr. Se realizó una investigación documental, a través de la búsqueda bibliográfica de artículos publicados en los últimos 5 años en idioma inglés y español, en bases de datos y buscadores científicos como PubMed, Elsevier, Scielo, Redalyc, Google Académico y DOAJ. La infección por VEB infecta al 90% de la población, se transmite principalmente por medio de la saliva, afecta a niños y adolescentes predominando en el sexo masculino. El antecedente de infección por el VEB ha sido asociado a capacidad oncogénica y dada la extensión cosmopolita que tiene es evidente la necesidad de investigarlo, especialmente cuando todavía no existe un tratamiento específico, ni vacuna para su profilaxis

El virus Epstein Barr (VEB) es un pat��geno ubicuo que ha infectado y permanece en m��s del 90% de la poblaci��n adulta, en part��culas infecciosas en c��lulas de tejidos, el virus establece una infecci��n latente de por vida, es uno de los virus m��s comunes en los seres humanos, adem��s se ha relacionado con una gran cantidad de enfermedades, entre la que destacan ciertos tumores y c��ncer de diferentes tipos. El objetivo de la investigaci��n fue analizar la prevalencia y las bases cient��ficas de la inmunopatog��nesis de la infecci��n por el virus Epstein Barr. Se realiz�� una investigaci��n documental, a trav��s de la b��squeda bibliogr��fica de art��culos publicados en los ��ltimos 5 a��os en idioma ingl��s y espa��ol, en bases de datos y buscadores cient��ficos como PubMed, Elsevier, Scielo, Redalyc, Google Acad��mico y DOAJ. La infecci��n por VEB infecta al 90% de la poblaci��n, se transmite principalmente por medio de la saliva, afecta a ni��os y adolescentes predominando en el sexo masculino. El antecedente de infecci��n por el VEB ha sido asociado a capacidad oncog��nica y dada la extensi��n cosmopolita que tiene es evidente la necesidad de investigarlo, especialmente cuando todav��a no existe un tratamiento espec��fico, ni vacuna para su profilaxis, {"references":["Vara Morate FJ, Soriano González MC, Garriguet López FJ, Valle Alonso ME. Síndrome de Alicia en el País de las Maravillas e infección por virus de Epstein-Barr. Pediatría Atención Primaria [Internet]. 2019;21(82):e67-70. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322019000200009","Medina-Ortega AP, López-Valencia D, Mosquera-Monje SL, Mora-Obando DL, Dueñas-Cuéllar RA. Virus de Epstein-Barr y su relación con el desarrollo del cáncer. Iatreia [Internet]. 2017;30(2):131-45. 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Introdução: A pancreatite aguda, com mortalidade geral de 20%, pode ocorrer como manifestação do vírus Epstein Barr (EBV), em primeira infecção ou em reativação viral com manifestações clínicas que se confundem com a infecção por SARS-COV 2 durante a pandemia de COVID-19. Diante da alta mortalidade, é necessária a confirmação etiológica para o manejo adequado. Objetivo: Relatar caso de pancreatite aguda com presença de EBV para alertar a comunidade médica da importância de incluir a infecção por EBV na investigação etiológica da pancreatite aguda. Metodologia: Relato de caso após coleta de dados através de revisão do prontuário médico e realização de revisão de literatura no período de 1981 a 2020, nas seguintes bases de dados: Pubmed, Scielo e Lilacs. Resultados e discussão: É relatado o caso de um homem de 47 anos o qual desenvolveu dor no abdômen e icterícia no sexto dia pós-colecistectomia. Durante a internação apresentou alterações nos exames seriados de amilase e lipase com níveis elevados: amilase 87; 192; 297 UI/L (30-110 UI/L) e lipase 376; 483; 386. Resultados do RT-PCR para SARS-COV 2 coletados por swab de nasofaringe em 2 amostras tiveram resultados negativos. Os resultados de colangioressonância sem presença de cálculos residuais, apresentou exames com níveis elevados e altos títulos do anticorpo IgG para EBV: Epstein Barr vírus igM: 40 U/ml) e Epstein Barr vírus IgG: > 750 U/ml (NR =20 U/ml). Recebeu tratamento conservador e evoluiu para melhora clínica, obtendo alta hospitalar. Conclusões: presente relato serve de alerta à população médica sobre a ocorrência de pancreatite aguda após colecistectomia videolaparoscópica e da necessidade de investigação etiológica com inclusão de exames de rastreamento para o EBV pela possibilidade de reativação viral pós-cirúrgica.

Objective. To evaluate the effectiveness of the natural terpenoids complex in preschool children with recurrent acute respiratory infections (ARI).Material and methods. There were examined 7129 children of 3-7 years old, they were divided into 3 groups. In main group (n = 2400) there was endonasally (on the mucous membrane of the nasal cavity with cotton buds) used a complex of natural terpenoids 2 times a day (morning and evening) 5 days a week for 1 - 3 months. Prevention and treatment of children from the comparison group (n = 2,379) was carried out with dioxotetrahydroxy tetrahydronaphthalene. The control group consisted of children (n = 2,350), who received no therapy. Upon completion of the course of therapy, children were examined in dynamics.Results. The authors noted positive clinical effect of the natural terpenoid complex, as evidenced by a 1.6 times decrease in acute respiratory infections during the year and the duration of the acute episode of the disease by 2.5 days, as well as a positive effect on the elimination of Epstein Barr virusin frequently ill children when using drug for 65.51 ± 2.98 days. The authors observed a favorable clinical effect against the decrease in neutrophils and eosinophils in the rhinocytogram, as well as mixed flora and cocci, indicating a decrease in mucosal neutrophilic inflammation and prevention of bacterial complications.

Resume L’infection par le virus d’Epstein-Barr (EBV) est une infection ubiquitaire, le plus souvent asymptomatique, et touchant plus de 95 % de la population mondiale ; c’est egalement une infection virale persistante associee a des cancers chez des individus immunocompetents ou immunodeprimes. Chez le patient greffe de cellules souches hematopoietiques (CSH) ou transplante d’organe solide, le deficit de controle de l’infection a EBV par le systeme immunitaire peut conduire a une lymphoproliferation ou syndrome lymphoproliferatif post-transplantation (SLPT). Le diagnostic du SLPT repose sur un faisceau d’arguments cliniques, biologiques et d’imagerie. La charge virale EBV (CVEBV) dans le sang est un marqueur sensible mais peu specifique de la survenue d’un SLPT. Elle est utilisee dans tous les centres dans le suivi des patients transplantes, mais aucun consensus n’existe a ce jour sur le seuil de CVEBV a partir duquel un traitement preemptif doit etre conduit. Chaque centre doit faire sa propre experience de suivi de la CVEBV : le laboratoire de virologie (matrice, unite de mesure ou seuil de CVEBV) et les services cliniques (interpretation des resultats dans le contexte clinique). Chez un patient dont la CVEBV augmente rapidement, le traitement preemptif EBV peut comprendre la levee de l’immunodepression et/ou l’instauration d’un traitement par le rituximab, un anticorps monoclonal anti-CD20 ciblant les lymphocytes B. Download : Download high-res image (187KB) Download : Download full-size image © SPL/PHANIE

To present a case of necrotizing retinitis with Epstein-Barr virus (EBV)-positive ocular fluid in a patient with sudden unilateral vision loss, which was successfully treated with intravitreal methotrexate (MTX) injections.Retrospective case report.An 83-year-old female who had been on methylprednisolone for 20 years due to interstitial pneumonia developed vitreous opacity and extensive necrotizing retinitis with retinal hemorrhage sparing the posterior pole in the left eye. Multiplex polymerase chain reaction (PCR) for viral DNA using vitreous sample was positive for EBV but negative for herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Real-time PCR detected EBV-DNA in aqueous humor but not in peripheral blood sample. Serologic testing was negative forIntravitreal MTX may be an effective treatment option for patients with necrotizing retinitis and EBV-positive ocular fluid not responding to conventional antiviral therapy.

Type I hypersensitivity is mediated by the production of IgE antibodies in response to normally harmless substances. Debate still continues about the mechanisms underlying allergic reactions. Reduced barrier tissue function can be one of the risk factors for allergies. The aim of the present work was to compare the humoral immune response to Epstein-Barr virus in patients allergic to the A. alternata fungus or D. farinae house dust mites and healthy donors. It is known that up to 90% of the world population are infected with EBV. This infection occurs at early age when a child develops allergy. The antibodies were analyzed using immuno-PCR and the recombinant EBV protein rEBNA. We were able to demonstrate that infection occurs at early age in both allergic patients and healthy donors. The proportion of EBP-seropositive individuals was comparable between the groups (75% and 74%). The proportion of patients with high IgG1 titers among patients with allergies was lower (7%) than in healthy donors (18%), suggesting a lower viral load. In patients with allergies (but not in healthy donors) IgG1 titers declined as children grew older (р = 0.037). Besides, IgA1 titers were increased in patients with allergies in comparison with healthy donors, but differed between patients allergic to A. alternata and house dust mites. In allergic individuals, production of IgM against EBV was triggered earlier than in healthy donors. We conclude that IgM production and the IgA1-mediated humoral response occur earlier in patients with allergies, causing a decline in IgG1 titers over time.

Aim. To identify the state of phagocytic and oxidative activity of phagocytes in the blood in patients with reactive arthritis caused by chlamydia and viral infections. Material and Methods. The investigation involved 97 patients with reactive arthritis (33 patients with reactive arthritis and EBV; 19 patients with reactive arthritis and dual infection - EBV and C. trachomatis; 28 patients with reactive arthritis and C. trachomatis; and 17 patients with reactive arthritis induced by tonsillitis). The study of phagocytic activity and "oxidative explosion" of neutrophils and monocytes was conducted using the technique of flow cytofluorometry. Results and Discussion. Neutrophil phagocytic activity after E.coli stimulation was reduced (p

Background: Systemic Epstein-Barr virus+ CD8+ T-cell lymphoma (sEBV+ CD8+ TCL) occurs in childhood and young adults, and exceptionally rare in older individuals. Methods: We investigated clinicopathological features in 16 patients of various ages with systemic EBV+ CD8+ T-lymphoproliferative diseases. Results: Eight younger and four of eight older patients had sEBV+ CD8+ TCL, with invasion by medium-sized to/or large atypical lymphocytes primarily in bone marrow and lymph nodes, hemophagocytic lymphohistiocytosis (HLH), and progressive clinicopathological course. Other two patients demonstrated EBV+ node-based CD8+ large TCL without HLH, while the remaining two had systemic form of chronic active EBV infection (sCAEBV) with CD8+ small lymphocytes. Past history of sCAEBV-like lesions was observed in one sEBV+ TCL patient (8.3%). Immunohistologically, in 12 sEBV+ TCL patients, atypical lymphocytes were positive for phosphate signal transducer and activator of transcription 3 (66.7%), CMYC (83.3%), and p53 (75%). Programmed cell death-ligand (PD-L)1+ tumor cells and strong reaction of PD-L1+ non-neoplastic cells were detected in nine sEBV+ TCL patients (75%). Clonal peaks of the T-cell receptor (TCR)γ gene were detected in eight sEBV+ TCL patients by polymerase chain reaction. Four younger patients in sEBV+ TCL (33.3%) are in remission with cytotoxic therapies including etoposide, and the three underwent allogeneic stem cell transplantation (SCT). Conclusion: sEBV+ CD8+ TCL was observed in younger and older patients with less history of sCAEBV. HLH, tumor cell atypia, immunohistological findings, and progressive clinical course were characteristic in sEBV+ CD8+ TCL. Prompt cytotoxic treatments and SCT induced tumor regression in sEBV+ CD8+ TCL patients.

Tests quantitatively measuring Epstein-Barr virus (EBV) DNA in peripheral blood are an important component of strategies for post-transplant lymphoproliferative disorder (PTLD) prevention, diagnosis, and management. This chapter summarizes current knowledge regarding EBV cell tropism, EBV DNA dynamics, and the biologic forms of EBV DNA in the cellular and acellular fractions of peripheral blood during acute and persistent EBV infection and in EBV+ PTLD. We highlight how this information influences choice of testing matrix, EBV DNA assay design, and result interpretation when using quantitative EBV DNA assays in specific clinical settings. The current status of result harmonization among assays is reviewed along with the impact of standards and calibrators, nucleic acid extraction methods, target and probe design, and other factors contributing to ongoing result variability. Testing of non-peripheral blood samples and possible future enhancements to EBV viral load measurement are also discussed.

Introducao: A ulceracao genital aguda, tambem conhecida como "Ulcera de Lipschutz ”, e uma condicao incomum, autolimitada, nao sexualmente transmissivel, caracterizada pelo inicio rapido de ulceracoes dolorosas na vulva ou vagina inferior. Materiais e Metodos: Relatamos um caso de uma adolescente, sem vida sexual ativa com faringite e ulceras vulvares dolorosas de inicio subito, alem de sorologia positiva para EBV. Discussao: A ulcera de Lipschutz , tem diagnostico essencialmente clinico e tratamento de suporte na maioria dos casos. Auto-resolucao sem cicatrizes e recidivas e o curso normal. Embora as causas e mecanismos especificos ainda nao sejam bem compreendidos, estudos mostraram associacao com infeccoes virais como EBV, assim como no nosso relato. Conclusao: Ressaltamos a importância do diagnostico acertado e diferencial nas ulceras vulvares afim de se evitar intervencoes e procedimentos desnecessarios e angustiantes para as pacientes.

The viruses in the herpesvirus group include herpes simplex, varicella-zoster, Epstein Barr, and cytomegalovirus. This chapter addresses both herpes simplex and varicella-zoster viruses. Herpes simplex cutaneous lesions are caused by the herpes simplex virus. Herpes zoster and varicella are caused by the virus varicella-zoster.

This study aimed to investigate the incidence of PTLD in pediatric liver transplant recipients and the risk factors for the development of PTLD. We also determined clinically useful quantitative EBV PCR parameters for aiding in the diagnosis of EBV-associated PTLD in the pediatric liver transplant recipients at our institute. We reviewed children < 18 years old who had undergone liver transplantations and quantitative analysis of whole blood EBV load at our institute from January 2006 to March 2015. A total of 142 liver transplant recipients were included, and their median age was 1.5 years. Clinically significant high-level EBV DNAemia ≥ 10 000 copies/mL at least twice was observed in 53.5% and PTLD occurred in 9.9%. Among PTLD group, graft failure and mortality rate were as high as 21.4% and 14.3%, respectively. Deceased donor, presence of high-level EBV DNAemia, and primary CMV infection following transplant were associated with an increased risk for PTLD in the multivariate analysis. The peak titer at 10 875 copies/mL could be used as a cutoff value with a sensitivity of 92.9% and a specificity of 37.9%; the rate of increase in EBV load suggested a sensitivity of 64.3% and a specificity of 70.9% at the cutoff value of 44 000 copies/mL/week. In conclusion, the incidence of PTLD following liver transplant in children was as high as 10%. PTLD is associated with significant morbidity and mortality. Close monitoring of EBV DNAemia is crucial for the early diagnosis and proper treatment of PTLD in pediatric liver transplant recipients.

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections are widely distributed throughout the world. EBV is linked to various hematological and autoimmune disorders whereas CMV might play important role in the progression of chronic hematological diseases, such as hemoglobinopathies, lymphomas, myelomas, hemophilia, and aplastic and sickle cell anemia. Both viruses produce a viral homolog of human interleukin-10 that can cause general suppression of immune response, increasing susceptibility to other infections. These viruses can remain latent in the host cells and be reactivated when the host immune system is compromised. Studies showing the impact of CMV and EBV infections on hematological disorders are scarce and unclear in the context of coinfection. This review intends to present the biology, prevalence, and impact of CMV and EBV infections in patients with hematological diseases.

Myocarditis is an uncommon but potentially life-threatening disease. Clinical manifestations could range from subclinical disease to sudden death, due to fulminant heart failure and/or malignant ventricular arrhythmias. The most common cause of myocarditis is viral infection, including Epstein-Barr virus (EBV). Nevertheless, EBV rarely presents with cardiac involvement in immunocompetent hosts. We report a case of acute EBV-related myocarditis in a young female, complicated with malignant ventricular arrhythmias and cardiac arrest. After 20 days of hospitalization and treatment, the patient was fit for discharge on pharmacological therapy (tapering steroids, beta-blockers, amiodarone, angiotensin-converting enzyme inhibitors, and diuretics). Clinical course is described, cardiac magnetic resonance images are shown. This case underlines how myocarditis is a disease that should not be underestimated: it could present with life-threatening complications such as malignant arrhythmias and/or severe systolic dysfunction.

Virus Epstein Barr (VEB) ha sido relacionado con una serie de tumores malignos de origen epitelial y linfoide. Existe una clara correlación entre este virus y enfermedades linfoproliferativas como Linfoma de Burkitt (LB), Linfoma Hodgkin (LH), Linfoma no Hodgkin (LNH) y carcinoma gástrico. Se han desarrollado diversas técnicas para la detección de VEB en células tumorales: hibridación in situ (RISH) que detecta RNAs (ácido ribonucleico) pequeños codificados para VEB (EBERs) en las células con infección latente, considerado el estándar de oro para la identificación del virus; la reacción en cadena de la polimerasa (PCR) que permite la detección de la cepa viral y representa un ensayo importarte en el diagnóstico del virus. Se realizó un estudio retrospectivo a partir de muestras de tejidos en parafina de pacientes con linfoma y se buscó al virus mediante PCR y RISH. La prevalencia del virus fue de 58,82%, el género más afectado fue el masculino y el grupo más afectado fue el de 31/40 años. La presencia del virus fue similar en ambos tipos de linfoma: Hodking y No Hodking. La técnica de RISH se mostró más eficiente para detectar la presencia del virus. AbstractEpstein Barr Virus (EBV) is linked to a number of malignant tumors of epithelial and lymphoid origin. There is a strong correlation between this virus and lymphoproliferative diseases such as Burkitt's lymphoma (BL), Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) and gastric carcinoma. There are various techniques developed to detect EBV in tumor cells: in situ hybridization (ISH) detects small coded RNAs (ribonucleic acid) to VEB (EBERs) in latently infected cells. This is considered the gold standard for virus identification. The polymerase chain reaction (PCR) allows the detection of the viral strain and represents an important fact in the virus diagnose. We conducted a retrospective study in paraffin from tissue samples of patients with lymphoma and we sought the virus through PCR and RISH. The virus prevalence was 58.82%, the most affected gender was male and the most affected group was 31/40 years. The virus was similar in both types of lymphoma: Hodgkin and non-Hodgkin. RISH technique seemed to be more efficient to detect the virus.

Aim. The investigate the current manifestations of the symptomatic and inapparent epidemic process of Epstein-Barr infection, as well as identification of its features in women of childbearing age and newborns. Materials and methods. We performed an epidemiological analysis of the incidence of infectious mononucleosis and HIV infection in the Russian Federation. The trends of morbidity and its distribution across the territories and age groups was studied. A study was made on the frequency of detection of infection markers in women of childbearing age, incl. HIV-infected pregnant women and newborns. Results. It has been established that despite the complexity of the diagnosis, the incidence of infectious mononucleosis should be considered as an indicator of the epidemic process of the Epstein-Barr infection. Unlike healthy pregnant women, in HIV-infected pregnant women markers of acute infection that occurred without clinical manifestations were observed significantly more frequent. The maximum intensity of the active epidemic process was detected among 15 - 19 years old pregnant women who are in the latent stage of HIV with intravenous drug abuse. In older age groups of pregnant women, reinfection was observed. High incidence in newborns, as well as detection of markers of acute infection indicate the need for further research to obtain strong evidence of vertical transmission of the pathogen. Conclusion. The study showed evidence of high activity of the epidemic process of Epstein-Barr infection in fertile women. The maximum frequency of infection markers was found among HIV-infected pregnant women, which increases the risk of intrauterine infection of the fetus and newborns.

Цель: исследовать клинические особенности инфекционного мононуклеоза (ИМ), вызванного вирусной инфекцией Эпштейн—Барр и микст-инфекцией — вирусом Эпштейн—Барр (ЭБВ) и цитомегаловирусом (ЦМВ), у детей.Пациенты и методы. Проанализированы 53 медицинские карты стационарного больного детей первых 5-ти лет жизни с диагнозом ИМ. Диагноз подтвержден результатами серологических исследований.Результаты. Более тяжелое течение заболевания наблюдалось у детей с ИМ, вызванным коинфекцией вирусов ЭБВ и ЦМВ. У больных с коинфекцией наблюдались повышенные уровни вироцитов в крови, более выраженные изменения биохимических показателей крови. Инфицированию ЭБВ предшествовало заражение ЦМВ, которое повлекло за собой бессимптомное течение цитомегаловирусной инфекции, однако эта инфекция реактивировалась на фоне иммунопатологических изменений в макроорганизме в ответ на контакт с ЭБВ.Выводы. Реактивация ЦМВ при острой ЭБВ!инфекции модифицировала клинику ИМ у детей — увеличилась частота тяжелого течения заболевания, однако это не повлияло на длительность болезни и ее последствия., Objective. To study the clinical particularities of infectious mononucleosis (ІМ) in the children caused by Epstein-Barr virus and coinfection of Epstein—Barr virus and cytomegalovirus.Material and methods. The medical records of 53 inpatient children up to 5 years of age, who were treated with a diagnosis IM were analyzed. The sample included patients whose diagnosis was confirmed by serological tests.Research results. More severe course of disease was observed in children with ІМ caused by coinfection of viruses. Patients with coinfection of viruses had higher levels of virocytes in blood and more expressed changes of some biochemical blood parameters. The CMV infection preceded EBV infecting that caused asymptomatic course of CMV infection, however this infection reactivated on a background of the immunopathological changes of macroorganism in reply to EBV infection.Conclusions. Reactivation of CMV infection on the background of an acute EBV infection modified the course of IM in children and caused increased incidence of severe disease, however it did not affect the duration of disease and its consequences., Мета: дослідити клінічні особливості перебігу інфекційного мононуклеозу (ІМ), спричиненого вірусною інфекцією Епштейн—Барр та мікст-інфекцією — вірусом Епштейн—Барр (ЕБВ) і цитомегаловірусом (ЦМВ), у дітей.Пацієнти і методи. Проаналізовано медичні карти стаціонарних хворих 53 дітей віком перших 5-ти років життя з діагнозом ІМ. У вибірку увійшли пацієнти, у яких діагноз був підтверджений результатами серологічних досліджень.Результати. Важчий перебіг захворювання спостерігався у дітей з ІМ, спричиненим коінфекцією вірусів — ЕБВ і ЦМВ. У хворих з коінфекцією спостерігалися вищі рівні віроцитів у крові, більш виразні зміни біохімічних показників крові. Інфікуванню ЕБВ передувало зараження ЦМВ, який спричинив безсимптомний перебіг цитомегаловірусної інфекції, однак ця інфекція повторно активувалася на тлі імунопатологічних змін у макроорганізмі у відповідь на контакт з ЕБВ.Висновки. Реактивація ЦМВ при гострій ЕБВ-інфекції модифікувала перебіг ІМ у дітей — зросла частота важкого перебігу захворювання, однак це не вплинуло на тривалість хвороби і її наслідки.