Monitoring of cell-free viral DNA in primary Epstein-Barr virus infection.
Primary Epstein-Barr virus (EBV) infection in childhood is usually asymptomatic, but sometimes causes infectious mononucleosis (IM). Very occasionally, IM develops into a life-threatening EBV-associated hemophagocytic syndrome (EBV-AHS). We studied the importance and usefulness of measuring cell-free viral DNA in the serum of patients with these primary EBV infections. Using real-time quantitative polymerase chain reaction, cell-free EBV-DNA was quantified in the serum of nine children with IM and three with EBV-AHS. In the acute phase of IM, an average of 10(2.4) copies/ml of EBV-DNA was detected in 95% of sera. The EBV load gradually decreased and disappeared within 1 month. Patients with EBV-AHS had an extremely high viral load in their sera (10(5.5)-10(7.4) copies/ ml). The viral load persisted longer in these patients, although it decreased in parallel with the improvement of symptoms. These results indicate that cell-free EBV-DNA was frequently detected in patients with primary EBV infection and could, therefore, be used as a marker for EBV infection. Measuring the cell-free EBV-DNA is useful for monitoring the primary EBV infection, especially in EBV-AHS.
Department of Pediatrics, Nagoya University School of Medicine, Japan. hkimura@med.nagoya-u.ac.jp
H
H
Kimura
K
K
Nishikawa
Y
Y
Hoshino
A
A
Sofue
Y
Y
Nishiyama
T
T
Morishima
D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D015616:Histiocytosis, Non-Langerhans-Cell / Q000150:complications / Q000821:virology*; D006801:Humans; D007223:Infant; D007244:Infectious Mononucleosis / Q000097:blood / Q000150:complications / Q000821:virology*; D019562:Viral Load
D004279:DNA, Viral