Behavioral, Virologic, and Immunologic Factors Associated With Acquisition and Severity of Primary Epstein-Barr Virus Infection in University Students
Behavioral, Virologic, and Immunologic Factors Associated With Acquisition and Severity of Primary Epstein-Barr Virus Infection in University Students
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DOI：
10.1093/infdis/jis646
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发表时间：
2013-01-01
影响因子：
6.4
通讯作者：
Hogquist, Kristin A.
中科院分区：
文献类型：
--
作者：
Balfour, Henry H., Jr.;Odumade, Oludare A.;Hogquist, Kristin A.
背景对大学生进行前瞻性研究，以确定原发性EB病毒（EBV）感染的发病率和危险因素，以及疾病严重程度的病毒学和免疫相关性。EBV抗体阴性的新生参加每月监测，直到毕业。如果产生抗体，则通过聚合酶链反应测定邻近样品的病毒载量。采用流式细胞术检测淋巴细胞和自然杀伤（NK）细胞的数量和活化，采用多重分析法检测血浆细胞因子水平。546名学生筛选，202（37%）是抗体阴性; 143抗体阴性的学生入学。在中位3年的观察期间，66例受试者发生原发性感染。其中，77%患有传染性单核细胞增多症，12%有非典型症状，11%无症状。报告有或没有性交的深度接吻的受试者比报告没有接吻的受试者有同样高的感染风险（P <0.01）。病毒血症是短暂的，但中位口服排毒时间为175天。在急性感染期间，观察到NK细胞和CD8（+）T细胞的数量增加，但CD4（+）T细胞的数量没有增加。疾病严重程度与血EBV载量（P = 0.015）和CD8（+）淋巴细胞增多（P = 0.0003）呈正相关。接吻是原发性EBV感染的一个显著风险。共有89%的感染是有症状的，血液病毒载量和CD8（+）淋巴细胞增多与疾病严重程度相关。
Background. University students were studied prospectively to determine the incidence of and risk factors for acquisition of primary Epstein-Barr virus (EBV) infection and the virologic and immune correlates of disease severity.Methods. EBV antibody-negative freshmen participated in monthly surveillance until graduation. If antibodies developed, proximate samples were assayed for viral load by polymerase chain reaction. Lymphocyte and natural killer (NK) cell numbers and activation were measured by flow cytometry, and plasma cytokine levels were measured by a multiplex assay.Results. Of 546 students screened, 202 (37%) were antibody negative; 143 antibody-negative students were enrolled. During a median of 3 years of observation, 66 subjects experienced primary infection. Of these, 77% had infectious mononucleosis, 12% had atypical symptoms, and 11% were asymptomatic. Subjects reporting deep kissing with or without coitus had the same higher risk of infection than those reporting no kissing (P < .01). Viremia was transient, but median oral shedding was 175 days. Increases were observed in numbers of NK cells and CD8(+) T-cells but not in numbers of CD4(+) T-cells during acute infection. Severity of illness correlated positively with both blood EBV load (P = .015) and CD8(+) lymphocytosis (P = .0003).Conclusions. Kissing was a significant risk for primary EBV infection. A total of 89% of infections were symptomatic, and blood viral load and CD8(+) lymphocytosis correlated with disease severity.