Principles of the treatment of chronic Epstein–Barr virus infection and associated diseases

Author:

Yakushyna S. A.1ORCID,Kisteneva L. B.1ORCID,Cheshyk S. G.1ORCID

Affiliation:

1. Gamaleya National Research Centre of Epidemiology and Microbiology

Abstract

Epstein – Barr virus, related to herpes viruses, causes infectious mononucleosis during the initial infection; after recovery, the virus persists in the body throughout lifetime. The presence of clinical symptoms and viral load in a patient in 6 months after the infectious mononucleosis disease indicates the formation of chronic active Epstein – Barr viral infection. Hemophagocytic lymphohistiocytosis, posttransplantation lymphoproliferative disease and chronic fatigue syndrome, which has a polyetiological nature, are also associated with the activation of the persistent Epstein – Barr virus. Most of these diseases develop in children due to their physiological immunodeficiency and are accompanied by high mortality – up to 50%. Immune mechanisms, in addition to the virus itself, play a leading role in the pathogenesis of the diseases. The article summarizes all existing approaches to the treatment of chronic Epstein – Barr virus-associated diseases. The authors have analyzed the effectiveness of these approaches on the basis of various published studies. These diseases are treated with etiotropic antiviral drugs – nucleoside analogs, nonspecific immunotherapy, targeted therapy with monoclonal antibody preparations, immune cellular CD8+ therapy. In case of ineffectiveness of these methods, the alternative bone marrow transplantation is used. The article highlightes promising areas for the development of new approaches to the treatment of Epstein – Barr virus-associated diseases.

Publisher

The National Academy of Pediatric Science and Innovation

Subject

Pediatrics, Perinatology, and Child Health

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1. Chronic Epstein-Barr viral infection in children: a clinical case;Meditsinskiy sovet = Medical Council;2021-11-01

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