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Abstract
This study aimed to investigate the relationship between Epstein-Barr virus (EBV) infection and the onset of juvenile idiopathic arthritis (JIA), disease activity, and response to treatment. The study included 44 children with JIA, 23 children with different types of arthritis, and 44 controls. We measured EBV infection markers, including the EBV DNA load and the concentration of antibodies to viral antigens, at disease onset, before treatment. Six months after JIA diagnosis and the initiation of treatment patients with anti-viral capsid antigen IgG had a higher disease activity and worse response to treatment than patients without previous infection. After six months of treatment, the probability of disease inactivity in children without a history of EBV infection was almost 6.5 times greater than in a child with a history of infection. Furthermore, the probability of a better response after six months of treatment in a child with a history of EBV infection was more than five times smaller than in a child without infection. A past EBV infection can have a negative effect on achieving disease remission and may be associated with a worse response to treatment. Our results do not indicate the need for routine assessment of EBV infection markers in patients with JIA.
Highlights
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic childhood disease of still unknown aetiology [1]
The prevalence of positive anti-viral capsid antigen (VCA) IgG was associated with Pediatric response criteria (PedACR) at month 6 of the disease (p = 0.049; Table 8) we evaluated the presence of Ab in patients with a poor (PedACR 30/50) and good (PedACR 70/90) response after three and six months of treatment (Table 9)
Our study did not confirm the relationship between Epstein-Barr virus (EBV) viremia or past EBV infection and the onset of JIA
Summary
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic childhood disease of still unknown aetiology [1]. Apart from genetic factors, environmental factors play a significant role in the pathogenesis of the disease [1,2,3]. Modern pharmacological therapies enable effective control of the disease, but many JIA patients experience exacerbations during therapy or do not respond to medications [1,3]. New data on the pathogenesis of JIA may allow for more effective interventions. One of the factors that may influence the development of the disease is infection by the Epstein-Barr virus (EBV). It has not yet been clarified whether EBV infection may be related to disease activity or patient response to treatment
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