Primary infection with the EpsteinâBarr virus (EBV) results in fatal infectious mononucleosis in up to 70% of males affected by the Xâlinked lymphoproliferative syndrome (XLP). This rare disease is often associated with diverse natural killer (NK)â, Bâ and Tâcell deficiencies. We describe experiments testing whether the B lymphocytes of affected males play a role in the pathogenesis of XLP due to a low susceptibility to Tâcellâmediated immunity. Using reverse transcriptionâpolymerase chain reaction (RTâPCR) and immunohistochemistry we detected in these B cells the expression of viral proteins EBNAâ1, EBNAâ2, EBNAâ3A, EBNAâ3C, LMPâ1 and LMPâ2A, which provide targets for cytotoxic T cells. Major histocompatibility complex (MHC) class I, MHC class II and the B7 costimulatory molecule were present on the cell surface. Accordingly, the EBVâinfected B cells were lysed in 51Crârelease assays by T lymphocytes sharing MHC determinants with the targets. This MHCârestricted and specific lysis was confirmed in competition experiments using MHCâspecific monoclonal antibodies (MAbs) and synthetic peptides. XLPâderived LCLs could also induce MHC class Iârestricted memory and cytotoxic T lymphocytes. Thus, these XLPâderived B cells resembled normal LCIs in vitro with respect to induction of EBVâspecific cytotoxic T cells (CTL), the ability to present EB viral antigens and the susceptibility to EBVâspecific and MHCârestricted CTLâmediated killing. The failure of the immune system to eliminate these virusâinfected B cells in XLP is clearly not caused by a Bâcellâspecific defect. Int. J. Cancer 76:694â701, 1998.© 1998 WileyâLiss, Inc.