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Epstein-Barr Virus

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  • Authors: Andrew Nowalk1, Michael Green2
  • Editors: Randall T. Hayden3, Donna M. Wolk4, Karen C. Carroll5, Yi-Wei Tang6
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: University of Pittsburgh School of Medicine, Division of Infectious Diseases, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224; 2: University of Pittsburgh School of Medicine, Division of Infectious Diseases, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224; 3: St. Jude’s Children’s Research Hospital, Memphis, TN; 4: Geisinger Clinic, Danville, PA; 5: Johns Hopkins University Hospital, Baltimore, MD; 6: Memorial Sloan-Kettering Institute, New York, NY
    • Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0011-2015
  • Received 08 May 2015 Accepted 08 February 2016 Published 24 June 2016
  • Michael Green, [email protected]
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  • Abstract:

    This review covers relevant clinical and laboratory information relating to Epstein-Barr virus (EBV) infections in immunocompromised hosts. It describes the epidemiology and clinical manifestations with a primary focus on disease in solid organ and stem cell transplant recipients. The review pays particular attention to diagnostic approaches, including serologic testing and imaging, with an expanded discussion on the role of measuring the EBV load in peripheral blood, identifying both strengths and limitations of this assay. Additional attention is paid to potential additional strategies of immunologic monitoring that may enhance the performance of EBV load monitoring.

  • Citation: Nowalk A, Green M. 2016. Epstein-Barr Virus. Microbiol Spectrum 4(3):DMIH2-0011-2015. doi:10.1128/microbiolspec.DMIH2-0011-2015.

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References

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22. Michelson P, Watkins B, Webber SA, Wadowsky R, Michaels MG. 2008. Screening for PTLD in lung and heart-lung transplant recipients by measuring EBV DNA load in bronchoalveolar lavage fluid using real time PCR. Pediatr Transplant 12:464–468. [PubMed][CrossRef]
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31. Macedo C, Zeevi A, Bentlejewski C, Popescu I, Green M, Rowe D, Smith L, Webber S, Metes D. 2009. The impact of EBV load on T-cell immunity in pediatric thoracic transplant recipients. Transplantation 88:123–128. [PubMed][CrossRef]
32. Smets F, Latinne D, Bazin H, Reding R, Otte JB, Buts JP, Sokal EM. 2002. Ratio between Epstein-Barr viral load and anti-Epstein-Barr virus specific T-cell response as a predictive marker of posttransplant lymphoproliferative disease. Transplantation 73:1603–1610. [PubMed][CrossRef]
33. Lee TC, Goss JA, Rooney CM, Heslop HE, Barshes NR, Caldwell YM, Gee AP, Scott JD, Savoldo B. 2006. Quantification of a low cellular immune response to aid in identification of pediatric liver transplant recipients at high-risk for EBV infection. Clin Transplant 20:689–694. [PubMed][CrossRef]
34. Schubert S, Renner C, Hammer M, Abdul-Khaliq H, Lehmkuhl HB, Berger F, Hetzer R, Reinke P. 2008. Relationship of immunosuppression to Epstein-Barr viral load and lymphoproliferative disease in pediatric heart transplant patients. J Heart Lung Transplant 27:100–105. [PubMed][CrossRef]
35. Green M, Bueno J, Rowe D, Mazariegos G, Qu L, Abu-Almagd K, Reyes J. 2000. Predictive negative value of persistent low Epstein-Barr virus viral load after intestinal transplantation in children. Transplantation 70:593–596. [PubMed][CrossRef]
36. Gross TG. 2009. Treatment for Epstein-Barr virus-associated PTLD. Herpes 15:64–67. [PubMed]
37. San-Juan R, Manuel O, Hirsch HH, Fernández-Ruiz M, López-Medrano F, Comoli P, Caillard S, Grossi P, Aguado JM, ESGICH PTLD Survey Study Group, European Study Group of Infections in Compromised Hosts (ESGICH) from the European Society of Microbiology and Infectious Diseases (ESCMID). 2015. Current preventive strategies and management of Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplantation in Europe. Results of the ESGICH Questionnaire-based Cross-sectional Survey. Clin Microbiol Infect 21:604.e1–604.e9. [PubMed][CrossRef]
38. Gross T, Orjuela MA, Perkins SL, Park JR, Lynch JC, Cairo MS, Smith LM, Hayashi RJ. 2012. Low-dose chemotherapy and rituximab for post-transplant disease (PTLD): A Children’s Oncology Group report. Am J Transplant 12:3069–3075. [PubMed][CrossRef]
39. Savoldo B, Goss JA, Hammer MM, Zhang L, Lopez T, Gee AP, Lin YF, Quiros-Tejeira RE, Reinke P, Schubert S, Gottschalk S, Finegold MJ, Brenner MK, Rooney CM, Heslop HE. 2006. Treatment of solid organ transplant recipients with autologous Epstein Barr virus-specific cytotoxic T lymphocytes (CTLs). Blood 108:2942–2949. [PubMed][CrossRef]
40. Ricciardelli I, Brewin J, Lugthart G, Albon SJ, Pule M, Amrolia PJ. 2013. Rapid generation of EBV-specific cytotoxic T lymphocytes resistant to calcineurin inhibitors for adoptive immunotherapy. Am J Transplant 13:3244–3252. [PubMed][CrossRef]
41. Ricciardelli I, Blundell MP, Brewin J, Thrasher A, Pule M, Amrolia PJ. 2014. Towards gene therapy for EBV-associated posttransplant lymphoma with genetically modified EBV-specific cytotoxic T cells. Blood 124:2514–2522. [PubMed][CrossRef]
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2016-06-24
2019-09-17

Abstract:

This review covers relevant clinical and laboratory information relating to Epstein-Barr virus (EBV) infections in immunocompromised hosts. It describes the epidemiology and clinical manifestations with a primary focus on disease in solid organ and stem cell transplant recipients. The review pays particular attention to diagnostic approaches, including serologic testing and imaging, with an expanded discussion on the role of measuring the EBV load in peripheral blood, identifying both strengths and limitations of this assay. Additional attention is paid to potential additional strategies of immunologic monitoring that may enhance the performance of EBV load monitoring.

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Epstein-Barr Virus
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Citation: Nowalk A, Green M. 2016. Epstein-barr virus. microbiolspec 4(3): doi:10.1128/microbiolspec.DMIH2-0011-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0011-2015.T1
TABLE 1

Cumulative 1- and 5-year incidence of PTLD in pediatric and adult SOT recipients by transplanted organ as reported in the 2010 Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients (OPTN/SRTR) Annual Report ( 9 )

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TABLE 1

Cumulative 1- and 5-year incidence of PTLD in pediatric and adult SOT recipients by transplanted organ as reported in the 2010 Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients (OPTN/SRTR) Annual Report ( 9 )

Source: microbiolspec June 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.DMIH2-0011-2015

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