PRIMARY EPSTEIN-BARR VIRUS-INFECTIONS IN AFRICAN INFANTS .2. CLINICAL AND SEROLOGICAL OBSERVATIONS DURING SEROCONVERSION
PRIMARY EPSTEIN-BARR VIRUS-INFECTIONS IN AFRICAN INFANTS .2. CLINICAL AND SEROLOGICAL OBSERVATIONS DURING SEROCONVERSION
复制标题
DOI：
10.1002/ijc.2910220305
复制
发表时间：
1978-01-01
影响因子：
6.4
通讯作者：
HENLE, W
中科院分区：
文献类型：
--
作者：
BIGGAR, RJ;HENLE, G;HENLE, W
在27名加纳婴儿中，前15个月每月检查一次。并在21个月时再一次，12例在1岁时获得性原发性EB病毒（EBV）感染，9例在随后的观察期内血清转化。血清转化未伴随显著的临床或身体疾病体征，并且没有一个婴儿根据血液学观察结果诊断为疑似传染性单核细胞增多症（IM）。12例早期血清转换者提供了最广泛的随访数据，表现出对EB病毒衣壳抗原（VCA）的一过性IG[免疫球蛋白]M抗体应答，在某些情况下，其滴度最初超过了相应的IgG抗体。2个月时观察到峰值VCA特异性IgG滴度。在血清转化后，与IM中观察到的结果相当。大多数婴儿产生了针对EBV诱导的早期抗原复合物的抗体，然而，如在伯基特淋巴瘤中观察到的，这些抗体针对R（限制性）组分，而不是针对D（弥漫性）组分，如在IM中观察到的。5例VCA特异性伊加抗体滴度较低。通常，EBV中和抗体已经存在于第一个抗VCA阳性血清中，但EBV相关核抗原抗体和抗体依赖性细胞介导的细胞溶解仅在血清转换后数月才可检测到。没有记录到嗜异性抗体应答，或至多几乎没有显著应答。试图证明咽拭子标本中的EB病毒遇到了有限的成功，表明在沉默血清转换的病毒排泄程度低。可能的解释之间的差异，临床，血液学和血清学反应原发性EBV感染在婴儿期和以后的生活进行了讨论。
Of 27 Ghanaian infants examined monthly for the first 15 mo. of life and once more at 21 mo., 12 acquired primary Epstein-Barr virus (EBV) infections by the age of 1 yr and 9 others seroconverted during the subsequent period of observation. The seroconversions were not accompanied by significant clinical or physical signs of illness and in none of the infants was a diagnosis of infectious mononucleosis (IM) suspected on the basis of hematologic observations. The 12 early seroconverters, providing the most extensive follow-up data, showed transient Ig[immunoglobulin]M antibody responses to EB viral capsid antigen (VCA) which in some cases initially exceeded the corresponding IgG antibodies in titer. Peak VCA-specific IgG titers were noted 2 mo. after seroconversion and were comparable to those seen in IM. Most of the infants developed antibodies to the EBV-induced early antigen complex which were directed however, against the R (restricted) component, as observed in Burkitt''s lymphoma, and not against the D (diffuse) component, as noted in IM. Low titers of VCA-specific IgA antibodies emerged in 5 cases. Usually, EBV-neutralizing antibodies were already present in the first anti-VCA-positive serum but antibodies to the EBV-associated nuclear antigen and antibody-dependent cell-mediated cytolysis became detectable only months after seroconversion. No heterophil antibody responses, or at most barely significant ones, were recorded. Attempts to demonstrate EBV in throat swab specimens met with limited success, suggesting a low degree of viral excretion during silent seroconversions. Possible explanations for the differences between clinical, hematologic and serologic responses to primary EBV infections in infancy and later in life are discussed.