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Description

Epstein-Barr virus (EBV) may rarely be associated with chronic, active infections. These can be diagnosed based on a combination of both clinical and serologic findings.


 

Clinical findings - 3 or more of the following:

(1) prolonged or recurrent episodes of fever and/or exanthem

(2) hepatosplenomegaly and/or lymphadenopathy

(3) chronic hepatitis and/or interstitial pneumonitis

(4) pancytopenia and/or virus-associated hemophagocytic syndrome

(5) hypersensitivity to mosquito bite, granular lymphocyte proliferative disease, and/or increased proportion of HLA-DR-positive T cells

 

Laboratory findings of elevated titers of serum antibodies against antigens of the viral replicative cycle: one or more of the following:

(1) anti-viral capsid antigen IgG (anti-VCA IgG): titer > 1:640

(2) anti-viral capsid antigen IgA (anti-VCA IgA): titer > 1:20

(3) anti-early antigen IgG (anti-EA IgG): titer > 1:160

 

The presence of both the clinical and laboratory findings is diagnostic for chronic active EBV infection.

 

NOTE: Although not given by the authors, I would imagine that the presence of 2 of the clinical findings plus the laboratory findings would qualify as a probable diagnosis.

 

Other findings:

(1) elevated levels of Epstein-Barr nuclear antigen

(2) high copy numbers of the EBV genome

 


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