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Epstein-Barr virus (EBV)

Epstein-Barr virus (EBV). By. Dr. Emad AbdElhameed Morad. Lecturer of Medical Microbiology and Immunology. Virological properties. Belong to herpesvirus family. It is an enveloped DNA virus. The envelope contains glycoprotein spikes on its surface. Viral antigens are:

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Epstein-Barr virus (EBV)

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  1. Epstein-Barr virus (EBV) By Dr. Emad AbdElhameed Morad Lecturer of Medical Microbiology and Immunology

  2. Virological properties • Belong to herpesvirus family. • It is an enveloped DNA virus. • The envelope contains glycoprotein spikes on its surface. • Viral antigens are: • Viral capsid antigen (VCA) • Early antigen (EA) • Epstein-Barr nuclear antigen (EBNA) • Viral membrane antigen (VMA)

  3. Structure of EBV

  4. Pathogenesis • Mode of infection: • EBV is transmitted by saliva (the kissing disease) • Very rarely by blood transfusion • Infection starts in the oropharynx then spreads to the blood. • In blood, the virus infects B lymphocytes. • In B lymphocytes, viral DNA integrates in cell genome. • Cytotoxic T lymphocytes react against infected B lymphocytes. • As a result, T lymphocytes change in morphology and appear as atypical lymphocytes.

  5. Diseases • EBV is the causative agent of infectious mononucleosis. • EBV is also associated with: • Burkitt’s lymphoma • B cell lymphomas • Nasopharyngeal carcinoma • Lymphoproliferative disorders in immunodeficient individuals. • Oral hairy leukoplakia in AIDS patients.

  6. Oral hairy leukoplakia

  7. Infectious mononucleosis • Infection with EBV in early childhood is a often asymptomatic and results in life long immunity. • BUT, when infection occurs in adolescence, 50% develop infectious mononucleosis (IM). • IM is characterized by: • Fever, sore throat • Enlarged lymph nodes and spleen • Rash may appear • Hepatitis is common

  8. Infectious mononucleosis

  9. Laboratory diagnosis • Complete blood picture shows: • Leucocytosis (25000/µl) with absolute lymphocytosis, monocytosis and atypical lymphocytes.

  10. Detection of heterophile antibodies that agglutinate: • Sheep red blood cells Paul Bunnell test • Horse red blood cells Mono-spot test • Detection of antibodies to EBV specific antigen by ELISA or immunofluorescence: • IgM to VCA Recent infection • IgG to VCA or EBNA Past infection

  11. Detection of EBV in the patient specimens like peripheral lymphocytes, saliva, throat washing by PCR or DNA probes. • Isolation of the virus from patient specimens is possible but difficult. • Note that cytomegalovirus (CMV) produces mononucleosis like syndrome. • CMV is differentiated from EBV by being heterophile antibody negative.

  12. GOOD LUCK

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