A Prospective Clinical Study of Epstein Barr Virus and Host Interactions During Acute Infectious Mononucleosis

¶ … Prospective Clinical Study of Epstein-Barr Virus and Host Interactions During Acute Infectious Mononucleosis Article Review Balfour et al. (2005) carried out the study with an aim of discovering how Epstein-Barr virus (EBV) replication is controlled. Using such information would offer them insights as to why some immunocompromised patients develop fatal or severe disease when they fail to contain EBV infection. According to Balfour et al. (2005), it is not easy to distinguish subjects with primary EBV from those with nonprimary EBV infection based on their symptoms and physical findings.

The most frequent complaint was tiredness and pharyngitis was the common physical finding. Subjects with nonprimary EBV infection also manifested longer periods of a sore throat and headaches. Nausea and abdominal pain were also common symptoms manifested by the subjects. The trajectory of illness severity was that the recovery rate of nonprimary EBV infection subjects was slower than that of primary EBV infection subjects. The severity of illness did not indicate a difference of infection based on sex. There was one subject whom Balfour et al.

(2005) recommended being rested from the study because she had a slow humoral immune response to the primary EBV infection. By the time she was been rested from the study, the researchers illustrated that her EBV profile was similar to that of someone who had a previous EBV infection. Eliminating EBV from the oropharynx was quite different from eliminating EBV from the whole blood.

The study established that the quantity of EBV found in the blood was directly related to the severity of primary EBV infection, but the quantity found in the oral wash fluid was not. Balfour et al. (2005) posit that the quantity of EBV found in whole blood is an indicator of primary EBV infection severity in young adults. The duration of symptoms can be predicted by monitoring the change in viremia.

The study contributes towards the understanding of EBV infection by providing data demonstrating the level and duration of viremia and oral shedding. Infectious mononucleosis is normally transmitted after an intimate oral contact that allows for the transfer of saliva. This is why infectious mononucleosis is referred to as the kissing disease. Balfour et al. (2005) arrived at this conclusion based on the large quantities of EBV they found in oral wash fluid from the young adults who had resumed normal social activities.

After the onset of infectious mononucleosis, oral shedding has been shown to persist for many months. The study carried out by Harold provides additional information that indicates the quantity of the virus in a person's oral secretions does not indicate the severity of the illness, but rather it could have an inverse relationship. Oral shedding was not intermittent, but rather it was continuous. The infectious period of the patient has been shown to be even during convalescence, and not only when the patient is ill.

This has was proven based on saliva collected from the subjects, which was shown to be infectious based on an in vitro cord-blood lymphocyte. Previously it was believed that EBV was produced in the saliva glands, and most recently, it has been shown to be produced by the B cells in the oropharynx. The blood has been shown to tightly control EBV-specific immunity better than the oropharynx. This Balfour et al.