RESUMEN
The worldwide burden of disease due to Epstein-Barr virus (EBV) infection is enormous. Diseases include endemic Burkitt lymphoma, infectious mononucleosis, cancers after transplantation, Hodgkin lymphoma, and nasopharyngeal carcinoma. A prophylactic EBV vaccine has the potential to significantly reduce the incidence and/or the severity of all these diseases. Infectious mononucleosis can be nasty and prolonged with a median duration of 17 days. Patients, especially children, undergoing bone marrow or solid organ transplantation may develop post-transplant lymphoproliferative disorder (PTLD). Preventing or modifying primary EBV infection could reduce the incidence PTLD, and also certain lymphomas and nasopharyngeal carcinoma. EBV is a major environmental risk factor for multiple sclerosis (MS). Contracting EBV is essential to getting MS, and having a childhood case of infectious mononucleosis increases that risk. Vaccinating against EBV could be vaccinating against MS.
Asunto(s)
Infecciones por Virus de Epstein-Barr/prevención & control , Herpesvirus Humano 4/inmunología , Enfermedad de Hodgkin/prevención & control , Carcinoma Nasofaríngeo/prevención & control , Neoplasias Nasofaríngeas/prevención & control , Infecciones Oportunistas/prevención & control , Vacunas Virales/uso terapéutico , Linfoma de Burkitt/inmunología , Linfoma de Burkitt/prevención & control , Linfoma de Burkitt/virología , Infecciones por Virus de Epstein-Barr/inmunología , Infecciones por Virus de Epstein-Barr/virología , Enfermedad de Hodgkin/inmunología , Enfermedad de Hodgkin/virología , Humanos , Mononucleosis Infecciosa/inmunología , Mononucleosis Infecciosa/prevención & control , Mononucleosis Infecciosa/virología , Carcinoma Nasofaríngeo/inmunología , Carcinoma Nasofaríngeo/virología , Neoplasias Nasofaríngeas/inmunología , Neoplasias Nasofaríngeas/virología , Infecciones Oportunistas/inmunología , Infecciones Oportunistas/virología , Trasplante de Órganos/efectos adversos , Medición de Riesgo , Factores de Riesgo , Vacunas Virales/efectos adversosRESUMEN
Background: A potential source of primary Epstein-Barr virus (EBV) infection for young children is parental oral secretions. If parents who identify with racial/ethnic categories other than white have a higher prevalence of oral EBV DNA, this difference could explain why their children acquire primary EBV infection at an earlier age than white children. Methods: To test this hypothesis, we recruited parents who brought their children <8 years old to routine clinic visits, and tested the parents' oral washes for EBV DNA by real-time polymerase chain reaction. Positive samples were assayed for encapsidated EBV DNA, which is potentially infectious, versus naked EBV DNA, which is not infectious. Results: Overall, 221/800 parents (28%) had EBV DNA in their oral washes. Oral EBV DNA was more prevalent in parents who identified as non-white as compared with white parents (P = .0004), and was more prevalent in male vs female parents (P = .04). The mean quantity of EBV DNA in positive samples was 5000 copies/mL. Encapsidated viral DNA comprised 40.3% of the total EBV DNA found in parental oral secretions. Conclusions: Our data support the hypothesis that parents could be a source of virus for their young children, because 28% of parents had a mean of 5000 EBV copies/mL of oral wash and 40.3% of the EBV DNA was encapsidated. The higher prevalence of EBV DNA in non-white parents could explain why their children acquire EBV at an earlier age than children of white parents.