A Common Infection That Sometimes Causes Complications
Epstein-Barr virus (EBV) is a very common virus.
This article discusses the Epstein-Bar virus and the diseases it causes.
It also goes over potential symptoms, treatment, and diagnosis.
Reproduced with permission from ©DermNet NZ www.dermnetnz.org 2022
What Is the Epstein-Barr Virus?
EBV is grouped with similar viruses categorized as double-stranded DNA viruses.
EBV is in the herpes family of viruses.
It is sometimes referred to as human herpesvirus 4.
The virus often first attaches to and infects certain cells that line your mouth.
The virus is named for Epstein and Barr, who discovered it in 1964.
Active Versus Inactive Infections
Infection with EBV includes an active phase and an inactive, latent phase.
During the active phase, the virus multiplies and spreads through the body.
You might or might not have symptoms from the virus during this time.
Sometimes, the inactive virus becomes active again.
Reactivation of the virus is particularly concerning for people who have impaired immune systems.
These people are more at risk for complications from EBV, like certain cancers.
Symptoms of Epstein-Barr Infection
Many people get infected with EBV and never experience any symptoms.
This is called asymptomatic infection.
When people get infected in childhoodas happens most commonlyEBV often causes no symptoms at all.
Some children get mild symptoms, like fever, that arent distinguished from other normal childhood illnesses.
Middle-aged adults first infected with EBV often dont have any symptoms either.
This most commonly shows up when people become infected with EBV during adolescence or early adulthood.
It might take several weeks after infection before you roll showing symptoms.
However, fatigue from mononucleosis can be debilitating, and it may last for weeks or months.
Mononucleosis also occasionally causes a persons spleen to enlarge.
Very rarely, this can lead to a serious problemspleen rupture.
Mononucleosis also sometimes also causes other very rare but serious symptoms, like encephalitis.
Notreatmentcurrently exists to directly treat mononucleosis.
Pain medications, hydration, and rest are the main treatment approaches.
This causes a serious syndrome called chronic active Epstein-Barr virus disease (CAEBV).
It can cause symptoms like fever, enlarged spleen, and liver disease.
CAEBV can also impair the immune system, making people much more prone to serious infections and lymphomas.
Complications of EBV Infection
There are complications linked to EBV infection.
Similarly, infection with EBV increases the risk of certain cancers.
A persons risk of gettingBurkitt lymphomais also increased after getting mononucleosis from EBV.
Other types of cancer associated with EBV include stomach cancers and nasopharyngeal carcinoma.
Some of the trouble from EBV comes from the fact that the body never really gets rid of it.
The virus inserts its DNA inside the host and can trick the body into making copies of viral proteins.
Some of these proteins affect key genes already in the DNA.
You might be told that your cancer is EBV positive.
That means that EBV and its proteins can be found in the cancerous cells of your body.
If thats the case, its likely the virus played a role in causing your cancer.
Its not clear why some people who have EBV develop cancers while most others dont.
Many factors are probably involved, including genetics and the presence of other infections.
People who areimmunocompromisedare particularly prone to developing cancers related to EBV.
For example, this applies to people with impaired immunity fromHIVor an organ or stem cell transplant.
However, this might change in the future, as we develop therapies that specifically address EBVs role.
This idea has been an especially popular one for practitioners of alternative or complementary medicine.
If it does play a role, it probably isnt involved in all cases of CFS.
And even if an infection triggers CFS in some people, factors other than EBV may be important too.
However, in some situations, you might need to get one or more antibody tests for EBV.
For example, they might be important if you are getting an organ transplant.
However, most people will never need testing for EBV.
How Is the EBV Virus Transmitted?
Most commonly, EBV is spread bysharing saliva.
Because EBV is spread so easily through kissing, it got its nickname as the kissing disease.
However, EBV can spread in other ways too.
you’re free to get it through sexual contact, blood transfusions, and organ transplants as well.
You are most likely to spread the virus if it is in its active phase.
People who get EBV may spread it for weeks before they have symptoms.
Preventing EBV Infection
Standard infection control measures can decrease the spread of the virus.
Many people shedding the virus won’t have any symptoms.
No vaccine is currently available to prevent infection with EBV.
It doesn’t always cause symptoms, but some people who are infected with it may develop mononucleosis.
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