title: Clearance of circulating Epstein-Barr virus DNA in children with acute malaria after antimalaria treatment.
abstract: Children living in malaria-endemic regions have a high incidence of Burkitt lymphoma (BL), the etiology of which involves Plasmodium falciparum malaria and Epstein-Barr virus (EBV) infections. In the present study, we compared EBV DNA loads in plasma and saliva samples from Ugandan children with acute malaria (M+) at the time of diagnosis and 14 days after antimalaria treatment, children without malaria (M-), and children with BL. EBV DNA was detected, by real-time polymerase chain reaction, in 31% of the plasma and in 79% of the saliva samples from children in the M+ group. Antimalaria treatment led to clearance of plasma viral load in 85% of the cases but did not affect the levels in saliva. There was a significant difference in plasma EBV loads across the groups. The lowest levels were detected in samples from the M- group, increased levels were detected in samples from the M+ group, and levels reached the highest values in samples from children with BL. The same trend was evident in the frequency and levels of anti-BZLF1 antibodies, which is indicative of viral reactivation. In the M+ group, the positive plasma samples clustered around 7-9 years of age, the peak incidence of BL. The clearance of circulating EBV after antimalaria treatment suggests a direct relationship between active malaria infection and viral reactivation.
authors.affiliation: Center for Infectious Medicine, Karolinska University Hospital--Huddinge, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Daria
authors.initials: D
authors.lastname: Donati
authors.forename: Eva
authors.initials: E
authors.lastname: Espmark
authors.forename: Fred
authors.initials: F
authors.lastname: Kironde
authors.forename: Edward Katongole
authors.initials: EK
authors.lastname: Mbidde
authors.forename: Moses
authors.initials: M
authors.lastname: Kamya
authors.forename: Ake
authors.initials: A
authors.lastname: Lundkvist
authors.forename: Mats
authors.initials: M
authors.lastname: Wahlgren
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Bejarano
authors.forename: Kerstin I
authors.initials: KI
authors.lastname: Falk
mesh_terms: D000293:Adolescent; D000375:Aging; D000914:Antibodies, Viral / Q000097:blood; D000962:Antimalarials / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis*; D004268:DNA-Binding Proteins / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000821:virology; D015534:Trans-Activators / Q000276:immunology; D014454:Uganda; D019562:Viral Load; D014764:Viral Proteins / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D000962:Antimalarials; C063676:BZLF1 protein, Herpesvirus 4, Human; D004279:DNA, Viral; D004268:DNA-Binding Proteins; D015534:Trans-Activators; D014764:Viral Proteins