Epstein–Barr virus
(EBV) is a ubiquitous gamma herpesvirus aetiologically linked to different lymphoid and epithelial malignancies and a number of systemic autoimmune diseases. The virus has a unique ability to transform resting B lymphocytes
in vitro
by expressing a set of latent genes, subsets of which are present in EBV‐associated tumours. EBV exploits the physiology of normal B‐cell differentiation to persist within the memory B‐cell pool of the immunocompetent host with strong T‐cell responses important for controlling EBV infection. Immunosuppressed transplant recipients and human immunodeficiency virus (HIV)‐infected individuals are at increased risk of developing EBV‐transformed B‐cell proliferations which often present as monoclonal non‐Hodgkin lymphomas. The major EBV‐associated tumours (Burkitt lymphoma, Hodgkin lymphoma and nasopharyngeal carcinoma) show restricted forms of latent viral gene expression reflecting a more complex pathogenesis involving additional cofactors. A number of pharmacological and immunotherapeutic approaches are being developed to treat or prevent these EBV‐associated tumours.
Key Concepts
Epstein–Barr virus
(EBV) infection is implicated in the aetiology of several different lymphoid and epithelial malignancies, as well as a number of systemic autoimmune diseases.
EBV exploits the physiology of normal B‐cell differentiation to persist within the memory B‐cell pool of the immunocompetent host.
EBV‐encoded latent genes induce B‐cell transformation
in vitro
by altering cellular gene transcription and constitutively activating key cell signalling pathways.
Immunosuppressed transplant patients are at risk of developing EBV‐transformed B‐cell proliferations presenting as B‐cell lymphomas.
Other EBV‐associated tumours display more restricted forms of latent gene expression, reflecting more complex pathogenesis involving additional cofactors.
EBV sequence variation may reflect disease risk.
Pharmacological and immunotherapeutic approaches are being developed to treat or prevent EBV‐associated tumours.
More direct vaccine approaches are being examined for the treatment and prevention of EBV‐associated diseases.