Academic Stress—Influence on Epstein-Barr Virus and Cytomegalovirus Reactivation, Cortisol, and Prolactin

Abstract

This study evaluated the effects of a common stressful event, academic examination, on (1) reactivation of latent Epstein-Barr virus (EBV) and cytomegalovirus (CMV) and (2) levels of cortisol and prolactin in serum. Blood samples were drawn from 2 groups of female students at the beginning of the semester (baseline) and during final examination periods (stress samples) of summer and fall-winter semesters. During summer, fall-winter, and overall, examination stress resulted in significantly increased levels of cortisol at P = .037, .016 and .004, respectively, but not prolactin (P = .32, .09 and .1, respectively). Examination stress significantly increased EBV viral capsid antigen (VCA) IgG levels from baseline levels (P = .0028) in the summer group, but not in the fall-winter group. In addition, the difference in frequency of reactivation in EBV-seropositive subjects in the summer vs the fall-winter (64% vs 15%) was significant at P = .005. Furthermore, after the examination, the percent increase of EBV VCA IgG in the summer (56%) was significantly different (P = .002) from the percent increase (–2%) in the fall-winter. On the other hand, examination stress did not affect the frequency of CMV reactivation or CMV IgG levels in either group. These data suggest that academic stress can reactivate some of the latent herpesviruses to various degrees at different seasons, and that in vivo reactivation of specific latent viral genes might involve multiple neuroendocrine interactions.