Downy cells12/13/2023 ![]() ![]() Nevertheless, late acquisition of primary EBV infection is also detrimental in several contexts. The authors speculated that early infection with “a large inoculum of EBV” explained why Eskimos were at high risk for nasopharyngeal carcinoma versus Danes who were not. Another study found that Greenland Eskimo children acquired primary EBV infection at an earlier age and had higher titers of IgG antibody against VCA than age-matched Danish children ( Melbye et al. For example, younger age at the time of primary EBV infection among Kenyan infants was associated with elevated levels of EBV viremia throughout infancy, leading the investigators to postulate that these infants were at higher risk for endemic Burkitt lymphoma ( Piriou et al. This is important to monitor because there is a complex interplay between age of acquisition, symptomatic versus asymptomatic infection, and the subsequent risk of EBV-associated cancers or autoimmune diseases. The age at which primary EBV infection is acquired may be increasing in developed countries ( Morris and Edmunds 2002 Takeuchi et al. The Twin Cities study showed that the divergence in age-specific antibody prevalence between blacks and whites was clearly apparent by the age of 5 years. These NHANEs findings were confirmed ( Condon et al., 2014) and extended to include younger children (18 months to 6 years of age) living in the Minneapolis-St. Within each race/ethnicity group, older age, lack of health insurance, and lower household education and income were statistically significantly associated with higher antibody prevalence. Thus, family environment and/or social practices may differ among white and non-white families, which could account for this disparity in antibody prevalence in younger children. Interestingly, the difference in antibody prevalence between whites and non-whites diminished during the teenage years. The greatest disparity in antibody prevalence was among the younger children, especially the 6- to 8-year-olds. children 6 to 19 years old enrolled in NHANES between 20 was substantially higher in non-Hispanic blacks and Mexican Americans than non-Hispanic whites ( Balfour et al. Regarding race/ethnicity, it was recently shown that antibody prevalence across all age groups of U.S. 1983), and school catchment area ( Crowcroft et al. 1998), maternal education ( Figueira-Silva and Pereira 2004), day care attendance ( Hesse et al. 1998), crowding or sharing a bedroom ( Sumaya et al. Other factors implicated are socioeconomic status ( Henle et al. 2007), and race/ethnicity ( Balfour et al. Factors clearly related to early acquisition of primary EBV infection include geographic region (reviewed in ( Hjalgrim et al. ![]() The prevalence of EBV antibodies in preadolescent children is lower, varying from 20% to 80% depending on age and geographic location. National Health and Nutrition Examination Surveys (NHANES) between 20 had IgG antibodies against EBV viral capsid (VCA) antigen, indicative of prior infection ( Balfour et al. A recent example is that 1037 (90%) of 1148 subjects 18 and 19 years old participating in the U.S. Key future challenges are to develop protective vaccines and effective treatment regimens.Ģ.1 Age-specific Prevalence of EBV AntibodiesĮBV infection is extremely common worldwide and approximately 90% of adults become antibody-positive before the age of 30 ( de-The et al. A major obstacle to understanding these sequelae has been the lack of an efficient animal model for EBV infection, although progress in primate and mouse models has recently been made. Several EBV related illnesses occur including certain cancers and autoimmune diseases, as well as complications of primary immunodeficiency in persons with the certain genetic mutations. In addition to causing acute illness, there can also be long-term consequences as the result of acquisition of the virus. EBV-specific antibody profiles are the best choice for staging EBV infection. A typical clinical picture with a positive heterophile test is usually sufficient to make the diagnosis, but heterophile antibodies are not specific and do not develop in some patients. How preadolescents acquire the virus is not known. The virus is spread by intimate oral contact among teenagers and young adults. EBV is a γ-herpesvirus that infects at least 90% of the population worldwide. It can be caused by a number of pathogens, but this chapter only discusses infectious mononucleosis due to primary Epstein-Barr virus (EBV) infection. Infectious mononucleosis is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever most often seen in adolescents and young adults and lasting several weeks. ![]()
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