title: Revisiting the effect of acute P. falciparum malaria on Epstein-Barr virus: host balance in the setting of reduced malaria endemicity.
abstract: Burkitt's lymphoma (BL), an EBV-associated tumour, occurs at high incidence in populations where malaria is holoendemic. Previous studies in one such population suggested that acute P.falciparum infection impairs EBV-specific T-cell surveillance, allowing expansion of EBV infected B-cells from which BL derives. We re-examined the situation in the same area, The Gambia, after a reduction in malaria endemicity. Cellular immune responses to EBV were measured in children with uncomplicated malaria before (day 0) and after treatment (day 28), comparing EBV genome loads in blood and EBV-specific CD8(+) T-cell numbers (assayed by MHC Class I tetramers and IFNγ ELISPOTS) with those seen in age- and sex-matched healthy controls. No significant changes were seen in EBV genome loads, percentage of EBV-specific CD8(+) T-cells and IFNγ producing T-cells in acute versus convalescent samples, nor any difference versus controls. Regression assays performed also no longer detected any impairment of EBV-specific T-cell surveillance. Acute uncomplicated malaria infection no longer alters EBV-specific immune responses in children in The Gambia. Given the recent decline in malaria incidence in that country, we hypothesise that gross disturbance of the EBV-host balance may be a specific effect of acute malaria only in children with a history of chronic/recurrent malaria challenge.
authors.affiliation: Medical Research Council Laboratories, Fajara, The Gambia.
authors.forename: Shamanthi
authors.initials: S
authors.lastname: Jayasooriya
authors.forename: Andrew
authors.initials: A
authors.lastname: Hislop
authors.forename: Yanchun
authors.initials: Y
authors.lastname: Peng
authors.forename: Debbie
authors.initials: D
authors.lastname: Croom-Carter
authors.forename: Ya
authors.initials: Y
authors.lastname: Jankey
authors.forename: Andrew
authors.initials: A
authors.lastname: Bell
authors.forename: Tao
authors.initials: T
authors.lastname: Dong
authors.forename: Sarah
authors.initials: S
authors.lastname: Rowland-Jones
authors.forename: Alan
authors.initials: A
authors.lastname: Rickinson
authors.forename: Michael
authors.initials: M
authors.lastname: Walther
authors.forename: Hilton
authors.initials: H
authors.lastname: Whittle
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D005260:Female; D005714:Gambia / Q000453:epidemiology; D004854:Herpesvirus 4, Human / Q000276:immunology*; D054884:Host-Pathogen Interactions; D006801:Humans; D007111:Immunity, Cellular; D015994:Incidence; D008288:Malaria / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D008297:Male; D010963:Plasmodium falciparum; D013601:T-Lymphocytes / Q000276:immunology / Q000821:virology; D019562:Viral Load