Chronic, active Epstein-Barr virus infection : Current Opinion in Hematology (original) (raw)
Leukocytes
Dept. of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Correspondence to Diane M Maia MD, Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Campus Box 7525, Chapel Hill, NC 27599-7525, USA
Abstract
Chronic active Epstein-Barr virus (EBV) infection is an uncommon outcome of EBV infection and may present as a waxing and waning or fulminant syndrome. Unlike acute infectious mononucleosis, wherein EBV establishes lifelong infection and survives by maintaining a delicate balance with the host as a latent infection, in chronic active EBV infection the host-virus balance is disturbed. The mechanisms by which this balance becomes perturbed are likely to be heterogenous and may involve host immune factors, viral factors, or both. A number of subtle immunologic defects have been reported in patients with chronic active EBV infection. Enhanced expression of viral genes has also been noted in some cases. Treatment of chronic active EBV infection has proven difficult, but new modalities including etoposide-based regimens and adoptive transfer of EBV-specific cytotoxic T lymphocytes have shown promise.
© 2000 Lippincott Williams & Wilkins, Inc.