Epstein-Barr virus replication in oral hairy leukoplakia: response, persistence, and resistance to treatment with valacyclovir.
Epstein-Barr virus replication in oral hairy leukoplakia: response, persistence, and resistance to treatment with valacyclovir.
复制标题
口腔毛状白斑中的 Epstein-Barr 病毒复制：对伐昔洛韦治疗的反应、持久性和耐药性。
DOI：
10.1086/378072
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Nichols,CMark
中科院分区：
文献类型：
--
作者：
Walling,DennisM;Flaitz,CatherineM;Nichols,CMark
本文报告19例人类免疫缺陷病毒（HIV）相关性口腔毛状白斑（HLP）和EB病毒（EBV）复制的患者，口服大剂量伐昔洛韦（valacyclovir）抑制EBV复制。在治疗前、治疗期间和治疗后获得的手术活检标本中评估了对治疗的临床、组织病理学和分子病毒应答。在大多数治疗病例中，HLP得到解决，EBV复制终止。在许多情况下，对复制抑制的最初反应是持续的、非生产性的口腔粘膜EBV感染，其特征是复制性EBV基因的有限表达，特别是BZLF 1。在某些情况下，生产性EB病毒复制复发后停止治疗伐昔洛韦。在少数接受治疗的病例中，治疗失败，并且生产性EBV复制持续存在，这可能是因为无环鸟苷耐药EBV的演变。总之，用伐昔洛韦安全治疗HLP和EBV复制，为EBV在口腔粘膜中持续存在的机制提供了新的见解
Nineteen cases of human immunodeficiency virus (HIV)–associated oral hairy leukoplakia (HLP) and Epstein-Barr virus (EBV) replication were treated with high-dose oral valacyclovir to inhibit productive EBV replication. The clinical, histopathological, and molecular viral responses to treatment were assessed in surgical biopsy specimens obtained before, during, and after treatment. In the majority of treated cases, HLP was resolved, and EBV replication was terminated. In many cases, the initial response to inhibition of replication was a persistent, nonproductive, EBV infection of the oral mucosa, characterized by limited expression of replicative EBV genes, especiallyBZLF1. In some cases, productive EBV replication recurred after discontinuation of treatment with valacyclovir. In a few treated cases, treatment failed, and productive EBV replication persisted, possibly because of the evolution of acyclovir-resistant EBV. In summary, safe treatment of HLP and of EBV replication, with valacyclovir, provides new insight into the mechanisms of EBV persistence in oral mucosa