Study of pathogenesis of chronic active EB virus infection and its treatment strategy.

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Epstein-Barr virus (EBV) genotypes can be distinguished based on gene sequence differences in EBV nuclear antigens 2 and 3C, and the BZLF1 promoter zone (Zp). EBV subtypes and BZLF1 Zp variants were examined in Japanese patients with chronic active EBV infection (CAEBV), infectious mononucleosis (IM), and EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH). EBV genotype in IM, CAEBV, and EBV-HLH all belonged to type 1. However, sequencing analysis of BZLF1 Zp found three polymorphic Zp variants. This is the first evidence that the EBV variant distribution in Japanese patients resembles that found in other Asian patients. Twenty-nine CAEBV-associated cellular genes were previously identified by microarray analysis of in vitro cultured cell lines derived from patients with CAEBV. In this study, we also investigated the expression levels of these cellular genes in the three EBV-related disorders including CAEBV, IM, and EBV-HLH, using real-time RT-PCR analysis.