Epidemiology of the Epstein–Barr Virus in Autoimmune Inflammatory Rheumatic Diseases in Northern Brazil

Abstract

The present study aimed to describe the seroprevalence infection, Epstein-Barr virus (EBV) genotypes, relate the infection’s profile with the epidemiological and corticotherapy data of patients with Autoimmune inflammatory rheumatic diseases (AIRD). A cross-sectional study was carried out with 139 individuals, 92 with systemic lupus erythematosus (SLE), 27 with rheumatoid arthritis (RA) and 20 with other autoimmune diseases, who were undergoing clinical follow-up in Brazil. Serological tests for the detection of EBV anti-VCA IgM and IgG antibodies, as well as the amplification of a segment of the EBV EBNA-3c gene by conventional PCR were performed to identify the infection and the viral subtype. The Epstein–Barr nuclear antigen 3 (EBNA3C) gene participates of maintenance of viral latency and infected B-lymphocytes immortalization by unclear signaling cascades. The association of active/latent EBV infection with EBV infection profile was assessed by Fisher’s exact test and multiple logistic regression. The seroprevalence of EBV anti-VCA IgG was 100%, while that of anti-VCA IgM was 1.43% (2/139). Active-phase infection was confirmed by the presence of EBV DNA in 40.29% of the population evaluated (56/139), with 45.65% (42/92) in SLE, 25.92% (7/27) in the RA and in 35% (7/20) in other autoimmune diseases. It was observed that individuals with SLE had a higher prevalence of active/lytic EBV infection and that oral corticosteroid therapy at a dose lower than 20 mg/day increased the risk of EBV activity by up to 11 times. Only the presence of EBV-1 was identified. Thus, EBV lytic infection was higher in individuals with SLE when compared to other autoimmune diseases with rheumatologic involvement and the lytic activity of the virus precedes corticosteroid-induced immunosuppression.

Epstein–Barr Virus Reactivation as a New Predictor of Achieving Remission or Lupus Low Disease Activity State in Patients with Systemic Lupus Erythematosus with Cutaneous Involvement

“…Several previous studies showed an increased prevalence of EBV reactivation compared to controls and an altered humoral response to EBV in lupus patients, but with a wide range of prevalence data described [ 13 , 15 , 16 , 17 , 18 , 19 , 20 ]. Similar to our findings, Franca et al and Han et al reported a prevalence of active EBV infection of 46.65% (versus 25.92% in patients with rheumatoid arthritis) and 39.66% (versus 10.53% in healthy controls), respectively [ 14 , 20 ]. However, some data suggest a prevalence of up to 78.2% of active EBV infection in lupus patients (versus 62% in controls) [ 13 ].…”

“…Considering that previous data suggested an association between EBV infection and SLE phenotype presenting with cutaneous and joint involvement, a separate analysis of the relationship between baseline clinical and viral parameters and the achievement of remission and LLDAS in these subgroups of SLE patients was performed [ 13 , 14 ]. The results of univariate and multivariate regression modeling are shown in Table 4 .…”

Systemic lupus erythematosus is associated with lower risk of hepatitis B virus infection: A multivariable Mendelian randomization study in East Asian population

“…Cirrhosis and liver cancer account for the primary causes of death in approximately 25% of individuals with chronic HBV infection 7 . Autoimmune diseases have been closely linked to viral infections, with studies connecting Epstein−Barr virus to SLE and rheumatoid arthritis (RA) 8 . Over several decades, a multitude of studies have reported a potential association between SLE and HBV infection, with the majority of observational studies demonstrating a reduced HBV infection rate among SLE patients 9–11 .…”

Special Issue ‘Viral Infection and Autoimmune Diseases’

“…In particular, they mentioned the relationship between EBV reactivation and the autoantibody production system and the importance of molecular mimicry. França et al [3] conducted a cross-sectional study on lytic changes in EBV in rheumatic diseases in northern Brazil. As a result, it was clarified that EBV lytic changes occurred before immunosuppression by steroids in patients with systematic lupus erythematosus.…”