Epstein-Barr infection: Current treatment options

Abstract

Epstein-Barr virus is one of the causes of known human cancers such as PLTD, BL and XLP. It is persistent in about 90% of the global population. Prevalent antiviral agents are not effective. A systematic review was undertaken to discuss current treatment options available for EBV infection. A search was made of PubMed to identify relevant papers published from 2000 to 2010 using various search indexes. The review is based on 11 articles included in the study. The result showed that there is no studies which analyzed antiviral agents in EBV infection. Combinational therapy using antiviral agents, immunotherapy and anticancer agents should be considered while antibiotic regimen should be considered to take care of any sepsis. Resistance to antiviral agents especially cross-resistance is burden in EBV infection Studies should be undertaken to evaluate resistance pattern in EBV infection. To assess the efficacy of EBV therapeutics. Viral load using molecular techniques should be used as biomarker of efficacy.

A case report of Epstein–Barr virus-associated retinal vasculitis: successful treatment using only acyclovir therapy

“… 8 Andersson et al found a significant reduction in spontaneous outgrowth of in vivo EBV-infected B-lymphocytes after acyclovir therapy. Meanwhile, some studies suggest that acyclovir, which effectively inhibits in vitro EBV production, 9 – 11 , 15 was the first-line regimen. Rafailidis et al 12 reviewed the usage of antivirals for severe EBV infection studies from PubMed and Scopus from 1982 to 2009 and found that acyclovir monotherapy was the most commonly prescribed antiviral regimen.…”

Viruses exploit the function of epidermal growth factor receptor

“…The mode of action of antiviral agents can be divided into three classes: (i) those that bind to or become incorporated into the viral nucleic acid thereby inhibiting its function; (ii) those that interfere with viral particle maturation, assembly or release; and (iii) those that interfere with the viral enzyme and inhibit their function. However, because of the variability in viral genomes, drug‐resistant strains occur frequently in clinical therapy, which makes exploring novel antiviral agents with different mechanisms of action urgent . The central role of the EGFR network in the life cycle of viral infections, its availability to extracellular manipulation, and detailed understanding of the underlying biochemistry have made the EGFR pathway an attractive target for antiviral therapy.…”

Ocular Manifestations in Epstein Barr Virus Infection

“…A significant correlation was found between elevated EBV titers and severe aqueous tear deficiency once the results were placed in multivariate analysis. This suggests that EBV infection could be a risk factor in developing aqueous tear deficiency [10,11].…”

“…The action of antiviral agents can be divided into: (1) disrupting with cellular process which the virus uses for its replication; (2) inhibits the function of the virus by bind to the nucleic acid; (3) modifies the viral envelope which is resulting in preventing the virus infecting new cells; (4) inhibits the formation of new progeny by interfering with viral assembly; (5) interferes with the viral enzyme and inhibits their function; (6) prevents the processing of viral precursor polypeptide. The effect of some of the antiviral agents used in EBV infection is uncertain, but some studies have reported good results of treating EBV infection with systemic antiviral [4,11].…”

“…Several antiviral drugs have been used to treat EBV infection and can be grouped into three as nucleoside analogs such as ganciclovir, valganciclovir, acyclovir, valaciclovir, acyclic nucleotide analog such as cidofovir and adefovir, and pyrophosphate analog such as foscarnet [11]. Acyclovir is recommended as the first-line drug for treating EBV infection.…”