Clinical and virologic characteristics of chronic active Epstein-Barr virus infection

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

“…There is accumulating evidence that the clonal expansion of EBV-infected T or NK cells plays a central role in the pathogenesis of chronic active EBV infection [93][94][95]. We proposed that this disease consists of a T cell-or NK cell-type disease, based on the results of PBMC fractionation and subsequent quantitative PCR [96][97][98]. EBVinfected T or NK cells with a latency type II pattern can evade the host cellular immune system due to the limited expression of viral proteins with reduced antigenicity [27,98,99].…”

“…Both PBMCs and plasma (or serum) have been used to estimate viral loads [96,[101][102][103]. EBV-infected T and NK cells migrate into the peripheral blood.…”

“…Such cell-free EBV DNA is sensitive to deoxyribonuclease digestion, indicating that it is episomal or naked DNA [98]. Interestingly, some patients do not have cell-free EBV DNA [96]. Compared to Hodgkin's lymphoma, EBV DNA is more cell-associated in the peripheral blood during chronic active EBV infection (Figure 2).…”

“…Compared to Hodgkin's lymphoma, EBV DNA is more cell-associated in the peripheral blood during chronic active EBV infection (Figure 2). Thus, PBMCs are desirable specimens for diagnostic purposes (Table 3), and in fact PBMCs from most patients with chronic active EBV infection have more than 10 2.5 copies/mg EBV DNA [96]. A higher viral load in the plasma has been associated with deteriorating clinical status [35,102].…”

Proposed guidelines for diagnosing chronic active Epstein‐Barr virus infection

“…The following clinical features are commonly noted in patients with CAEBV [19][20][21]. Symptoms are persistent and chronic and generally consist of prolonged or intermittent fever, lymphadenopathy, and/or hepatosplenomegaly.…”