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Antiviral Drugs as Tools for Nanomedicine
Published in Devarajan Thangadurai, Saher Islam, Charles Oluwaseun Adetunji, Viral and Antiviral Nanomaterials, 2022
Epstein–Barr virus (EBV), which are associated with B cell lymphomas, nasopharyngeal and gastric carcinomas. The Epstein–Barr virus (EBV), also called human herpesvirus 4 (HHV-4), is the virus of herpes family, and it is one of the most common viruses in humans. It is best known as the cause of infectious mononucleosis – glandular fever. The Epstein–Barr virus (EBV) infection is linked to the development of a variety of human malignancies, including Burkitt’s lymphoma, Hodgkin’s disease, nasopharyngeal carcinoma, some T cell lymphomas, post-transplant lymphoproliferative disease, and certain cancers of the stomach and smooth muscle and central nervous system lymphomas associated with HIV (Baumforth et al. 1999; Kanda et al. 2019; Wang et al. 2021; Vockerodt et al. 2015).
Diagnostic Approach to Fulminant Hepatitis in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
The Epstein–Barr virus (EBV), also called human herpesvirus-4 (HHV-4), belongs to the herpesvirus family and is one of the most common human viruses. It causes infectious mononucleosis, which results in fever, sore throat, enlarged lymph nodes in the neck, vomiting, and fatigue. Symptoms of mild hepatitis and cholestasis occur in approximately 90% of infected individuals [20]. It is often spread through contact with saliva and rarely through semen or blood. In a study of ALF patients enrolled into the US ALFSG, 0.21% of the participants were found to have EBV-related ALF, reflecting the rare occurrence of ALF in EBV [20]. These cases of ALF, however, were associated with a high fatality rate. Although clinically significant hepatic damage usually occurs in immunosuppressed patients, acute severe hepatitis in young, immunocompetent patients has been reported [21]. The diagnosis is made by the presence of positive EBV viral capsid antigen (VCA) IgM with or without positive EBV VCA IgG antibody titers or serum measurements of EBV DNA through PCR [20]. Compared with other viruses, ALF caused by EBV typically presents with a cholestatic enzyme pattern, with variable serum aminotransferase levels and jaundice [22]. Patients may or may not have the classical symptoms of infectious mononucleosis at presentation. The small number of EBV-related ALF cases makes potential ALF risk factors difficult to identify (Table 23.2).
Viruses
Published in Loretta A. Cormier, Pauline E. Jolly, The Primate Zoonoses, 2017
Loretta A. Cormier, Pauline E. Jolly
Human herpesvirus 4, or Epstein-Barr, is a Lymphocryptovirus and the agent of mononucleosis; it is a common virus worldwide with most individuals exposed by adulthood (Johannsen and Kaye 2015). It is transmitted through saliva and for this reason is sometimes referred to as the “kissing disease” (Grinde 2013). In children, it is often asymptomatic, but after adolescence, symptoms may include fever, sore throat, fatigue, and lymph-adenopathy (Grinde 2013). Epstein-Barr has also been associated with malignant disease, including Burkitt’s lymphoma and Hodgkin’s lymphoma (Johannsen and Kaye 2015). Human herpesvirus 5 is a Cytomegalovirus that is widespread and usually asymptomatic, but it can cause severe congenital abnormalities in infants infected in utero and may also cause severe disease in immunocompromised patients (Crumpacker 2015). Cytomegalovirus is also associated with a number of lymphomas (Grinde 2013). As with the other herpesviruses, after the initial infection, it can persist as a latent virus (Crumpacker 2015). Herpesviruses 6–8 are relatively rare. Types 6–7 are referred to as roseola viruses and can cause skin lesions and fever in infants less than two years of age (Grinde 2013). Human herpesvirus type-8 is associated with Kaposi’s sarcoma in immunocompromised individuals with HIV-AIDS (Grinde 2013). However, classic Kaposi’s sarcoma is not associated with immune dysfunction has been documented for over a century in people of Mediterranean, Eastern European, and Middle Eastern heritage, particularly in men (Iscovich et al. 2000).
Infectious Mononucleosis: diagnosis and clinical interpretation
Published in British Journal of Biomedical Science, 2021
P Naughton, M Healy, F Enright, B Lucey
EBV is a double-stranded DNA oncogenic virus classified under the order Herpesvirales as belonging to the Herpes family of viruses, Herpesviridae. These can be further classified into three subfamilies: α, β and γ (Table 1) [37]. Alpha-herpesvirinae include Human herpesvirus 1 and 2 (HHV-1 and HHV-2) commonly referred to as herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and Human herpes virus 3 (HHV-3) (more commonly known as the Varicella-zoster virus (VZV)) which cause herpes labialis/genitalis and chicken-pox, respectively. Beta-herpesvirinae include Human cytomegalovirus (CMV) or Human herpesvirus-5 (HHV-5) and Roseolovirus (HHV-6, HHV-7) which can cause infectious mononucleosis like infections (IML) and Roseola Infantum, respectively [6,11,37]. Gamma-herpesvirinae include EBV (Human herpesvirus 4, HHV-4) the causative agent of IM which is also implicated in several human cancers including Burkitt’s lymphoma, Hodgkin’s and T-cell lymphomas and various gastric and nasopharyngeal carcinomas [9,38–41]. EBV is also associated with several autoimmune diseases including systemic lupus erythematosus and multiple sclerosis (MS) [34,42–46]. It is also implicated in associated cases of acquired hemophagocytic lymphohistiocytosis (HLH) [20,47]. The second virus in this subgroup is Kaposi’s sarcoma-associated virus (KSHV) or more formally known as Human herpes virus 8 (HHV8) responsible for Kaposi’s sarcoma [48].
Clozapine-related drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a systematic review
Published in Expert Review of Clinical Pharmacology, 2020
Renato de Filippis, Pau Soldevila-Matías, Pasquale De Fazio, Daniel Guinart, Inmaculada Fuentes-Durá, Jose M. Rubio, John M. Kane, Georgios Schoretsanitis
For two patients, clinicians considered immunological tests [31,46] (Supplementary Table 4). In one patient, an interferon-gamma (IFN-γ) test response was assessed under corticosteroid suppression and again 3 months after discontinuation of corticosteroid therapy and the authors reported a marked increase thus implicating metamizole, paracetamol, and phenytoin, but not clozapine [31]. In the same patient, serologic tests for viral infections not including any herpesvirus other than Epstein-Barr virus (HHV-4) were negative [31]. Likewise, in another patient, serologic tests for human herpesvirus 4 (HHV-4), 6 (HHV-6), and 7 (HHV-7) were negative [46]. For one patient, viral hepatitis B and C were ruled out [45]. Elevated c-reactive protein (CRP) levels were reported in three patients.
Multiple Evanescent White Dot Syndrome Following Acute Epstein-Barr Virus Infection
Published in Ocular Immunology and Inflammation, 2019
Chang-Sue Yang, Ming-Hung Hsieh, Huan-I Su, Yih-Shiuan Kuo
EBV is a double-stranded DNA virus of the herpes family (human herpesvirus 4).19 The virus is transmitted through saliva and initially infects epithelial cells in the oropharynx and nasopharynx. EBV then enters the underlying tissues and infects the B lymphocyte. 20–22 The EB virus may either cause a lytic infection leading to cell death, or a nonproductive latent infection. We proposed two hypotheses regarding how EBV affects the eyes: the infectious or the autoimmune etiology. In Case No. 3, positive EB-VCA IgM antibody during the acute stage and preceding URI symptoms 1 week before MEWDS onset might suggest an infectious etiology. The virus may have directly caused the retinitis. We proposed that EBV-infected B cell may hematogenously travel to the retina by crossing the blood retina barrier (BRB) or by crossing the choriocapillaris and the retinal pigment epithelium (RPE) cell barrier. The epithelial cells may be the reservoir of infection. Tiedeman also suggested that the RPE cells may be the site for EB virus replication in patients of multifocal choroiditis.16 In the literature, positive Epstein-Barr virus capsid antigen (EB-VCA) antibodies were reported in 10 patients of multifocal choroiditis, compatible with recent or continuing Epstein-Barr virus infection.16 Raymond et al. also described punctate outer retinitis in a confirmed case of acute EBV infectious mononucleosis.23