Epstein-Barr virus antibodies are found in over 90% of all adults. Childhood infections are usually asymptomatic, while EBV infection in young adults results in infectious mononucleosis. Lymphoproliferative disorders may develop in transplant recipients taking cyclosporine and in patients with AIDS. EBV is epidemiologically associated with Burkitt lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, and nasopharyngeal carcinoma, and has also been reported in EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH), also known as EBV-associated hemophagocytic syndrome. This disease develops mostly in children and young adults and may be fatal. EBV has also been reported as a cause of pediatric acute renal failure. A highly sensitive PCR assay is available for detecting primary EBV infection and infectious mononucleosis.
Treatment of acute disease is largely supportive, although the EBV DNA polymerase is sensitive to acyclovir and ganciclovir, which decrease viral replication in tissue culture. No vaccine is currently available against EBV, but research is ongoing; it is estimated that an EBV vaccine could prevent 2% of cancers worldwide.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.