18.EBV_Treatment_Flashcards

Question 1

What is EBV, and what subfamily does it belong to?

Answer 1

Epstein-Barr Virus (EBV) is a member of the γ-Herpesviridae subfamily. It is lymphotropic and establishes latency in lymphoid tissues.

Question 2

What are the key characteristics of EBV?

Answer 2

1. Narrow host range.
2. Grows in lymphoblastoid cells.
3. One serotype, encodes ~100 genes.
4. No virion polymerase.
5. Viral capsid antigen (VCA) is the most important diagnostic antigen.

Question 3

How is EBV transmitted and replicated?

Answer 3

1. Transmitted via saliva (kissing or sharing utensils).
2. Infects the pharynx → cervical lymph nodes → blood (viremia) → disseminates to the liver and spleen.
3. Replicates in nasopharyngeal epithelium.

Question 4

Where does EBV establish latency?

Answer 4

EBV establishes latency in:
- B-lymphocytes.
- Oropharyngeal epithelial cells.
DNA copies persist in the cytoplasm or nuclei of lymphoid cells.

Question 5

What diseases are caused by EBV?

Answer 5

1. Infectious Mononucleosis (glandular fever): Fever, pharyngitis, lymphadenopathy; self-limiting in 2 weeks.
2. Asymptomatic infection in most children.
3. Oncogenic associations:
   
   • Burkitt’s Lymphoma.
   • Hodgkin’s Lymphoma (B-cell malignancy).
   • Nasopharyngeal Carcinoma.
   • Oral Hairy Leukoplakia (in immunosuppressed).

Question 6

What is EBV’s role in oncogenesis?

Answer 6

EBV is associated with:
- Burkitt’s Lymphoma (Africa).
- Hodgkin’s Lymphoma.
- Nasopharyngeal Carcinoma (Asia).
- CNS Lymphoma (in AIDS patients).

Question 7

How is EBV diagnosed?

Answer 7

1. Blood findings: Absolute lymphocytosis, atypical lymphocytes (Downey cells).
2. Isolation: Virus isolated from saliva, blood, lymphoid tissues.
3. Serology:
   
   • ELISA/IFA to detect viral capsid antigen (VCA).
   • Paul-Bunnell Monospot Test for heterophile antibodies (RBC agglutination).

Question 8

What is the role of Acyclovir in treating EBV?

Answer 8

Acyclovir reduces EBV oropharyngeal shedding but has no effect on symptoms of infectious mononucleosis or EBV-associated lymphomas.

Question 9

What is the general approach to treating infectious mononucleosis caused by EBV?

Answer 9

Supportive care: Bed rest and good sleep expedite recovery. No antiviral treatment is generally required.

Question 10

Is there a vaccine available for EBV?

Answer 10

No, there is currently no vaccine available for EBV prevention.