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Abstract
SummaryBackgroundPrimary Epstein-Barr virus (EBV) infection is usually asymptomatic, although at times it results in the benign lymphoproliferative disease, infectious mononucleosis (IM), during which almost half of patients develop hepatitis. The aims of the present study are to evaluate polymorphisms of EBV genes circulating in IM isolates from this geographic region and to investigate the correlation of viral sequence patterns with the available IM biochemical parameters.MethodsThe study included plasma samples from 128 IM patients. The genes EBNA2, LMP1, and EBNA1 were amplified using nested-PCR. EBNA2 genotyping was performed by visualization of PCR products using gel electrophoresis. Investigation of LMP1 and EBNA1 included sequence, phylogenetic, and statistical analyses.ResultsThe presence of EBV DNA in plasma samples showed correlation with patients’ necessity for hospitalization (p=0.034). The majority of EBV isolates was genotype 1. LMP1 variability showed 4 known variants, and two new deletions (27-bp and 147-bp). Of the 3 analyzed attributes of LMP1 isolates, the number of 33-bp repeats less than the reference 4.5 was the only one that absolutely correlated with the elevated levels of transaminases. EBNA1 variability was presented by prototype subtypes. A particular combination of EBNA2, LMP1, and EBNA1 polymorphisms, deleted LMP1/P-thr and non-deleted LMP1/P-ala, as well as genotype 1/ 4.5 33-bp LMP1 repeats or genotype 2/ 4.5 33-bp LMP1 repeats showed correlation with elevated AST (aspartate aminotransferase) and ALT (alanine transaminase).ConclusionsThis is the first study which identified the association between EBV variability and biochemical parameters in IM patients. These results showed a possibility for the identification of hepatic related diagnostic EBV markers.
Highlights
Epstein-Barr virus (EBV) is a highly prevalent gammaherpesvirus that persistently infects more than 90% of humans by the time of adulthood
Primary EBV infection is usually asymptomatic, at times it results in the benign lymphoproliferative disease, infectious mononucleosis (IM), especially in later childhood or young adulthood in developing countries [1]
EBV DNA was detected in 33/128 plasma samples (25.8%) with similar distribution between male (28.2%) and female (22.8%) patients
Summary
Epstein-Barr virus (EBV) is a highly prevalent gammaherpesvirus that persistently infects more than 90% of humans by the time of adulthood. Primary EBV infection is usually asymptomatic, at times it results in the benign lymphoproliferative disease, infectious mononucleosis (IM), especially in later childhood or young adulthood in developing countries [1]. IM is a self-limiting disease which resolves spontaneously after the emergence of EBV-specific immunity. The classical presentation of IM includes fever, oropharyngitis, malaise, lymphadenopathy, hepatosplenomegaly with elevated hepatic transaminases in up to 80% of patients [3]. Elevated transaminase levels are typically less than five times the upper limit of normal levels and rarely exceed 1000 U/L [4]. Hepatitis is benign, manifested by transient liver enzyme elevations and resolves spontaneously within 5 weeks [6]. Complications like a cholestatic pattern of severe hepatitis and even fatal liver failure are rare [5]
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