Interferon-alpha therapy for chronic active Epstein-Barr virus infection: potential effect on the development of T-lymphoproliferative disease.
OBJECTIVE
A patient with aggressive chronic active Epstein-Barr virus (CAEBV) infection is described whose disease activity subsided after interferon (IFN)-alpha therapy.


METHODS
The patient had intermittent fever, cytopenia, liver dysfunction, hepatosplenomegaly, abnormal titers of EBV-associated antibodies, and positive EBV genomes.


RESULTS
Despite repeated trials of the antiviral agents prednisolone and gamma-globulin, his condition deteriorated. The administration of IFN-alpha (1 x 10(5) U/kg subcutaneously 3 times per week) led to a dramatic clinical improvement. During the IFN-alpha therapy, the rearrangement bands of T-cell antigen receptor genes disappeared assessed by Southern blotting with a decrease in the number of activated T cells, although the EBV-genome remained evident.


CONCLUSIONS
These observations suggest that IFN-alpha is useful in managing CAEBV, possibly restraining the clonal development of T-lymphoproliferative disease (LPD) and EBV-associated B-LPD, although it does not eradicate the proliferation of EBV.
Sakai
Y
Y
Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ohga
S
S
Tonegawa
Y
Y
Takada
H
H
Nakao
F
F
Nakayama
H
H
Aoki
T
T
Yamamori
S
S
Hara
T
T
D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D004854:Herpesvirus 4, Human / Q000187:drug effects / Q000472:pathogenicity; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications / Q000188:drug therapy*; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D008213:Lymphocyte Activation / Q000187:drug effects; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000517:prevention & control* / Q000821:virology; D008297:Male; D012074:Remission Induction; D013601:T-Lymphocytes / Q000187:drug effects*; D014412:Tumor Virus Infections / Q000188:drug therapy* / Q000821:virology; D014775:Virus Activation / Q000187:drug effects
D000998:Antiviral Agents; D016898:Interferon-alpha