A Cohort Study among University Students: Identification of Risk Factors for Epstein‐Barr Virus Seroconversion and Infectious Mononucleosis

Abstract

Our findings suggest that acquisition of EBV is enhanced by penetrative sexual intercourse, although transmission could occur through related sexual behaviors, such as "deep kissing." We also found that EBV type 1 infection is significantly more likely to result in IM. Overall, the results suggest that a large EBV type 1 load acquired during sexual intercourse can rapidly colonize the B cell population and induce the exaggerated T cell response that causes IM. Thus, IM could, perhaps, be prevented with a vaccine that reduces the viral load without necessarily inducing sterile immunity.

HLA class I polymorphisms are associated with development of infectious mononucleosis upon primary EBV infection

“…The study was approved by the Lothian Research Ethics Committee, and all participants provided written signed consent. Details for enrollment and serotyping have been published elsewhere (6,7). In brief, all students enrolling at the university during 1999 and 2000 were approached to take part in the study, and upon recruitment, provided a blood sample for EBV serology.…”

“…Primary infection generally occurs in early childhood and is usually subclinical; however, in older patients, it manifests as IM in 25%-70% of cases (6,7). After primary infection, EBV establishes latency in B lymphocytes with virus production in the oropharynx and is spread via saliva.…”

“…One theory suggests that the size of the initial viral inoculum is a contributory factor in that a large dose, possibly acquired through sexual contact between young adults, would result in a high level of T cell stimulation and hence the immunopathological symptoms of IM (6,7). This theory is supported by the significant association reported between severe symptoms, high viral load, and increased T cell activation (2).…”

Kissing and hpv: Honest Popular Visions, the Human Papilloma Virus, and Cancers

“…Viral infections such as hepatitis, verruca vulgaris, Epstein-Barr viral mononucleosis 6 , and hiv are transmitted not only through close sexual contact, but also through exchange of bodily fluids (saliva) from kissing. Once considered rarely transmissible by saliva, hiv is now acknowledged to be transmissible during intimate kissing.…”

Evaluation of infectious mononucleosis status among a cohort of dental students

“…4 IM is a self-limiting illness and the range varies from flu like illness to debilitating disease ranging to months, chronic and fatal cases have also been reported. 5 The virus targets the memory B lymphocytes and accelerates its proliferation resulting in the cell mediated immune response which produces a clonal expression of T cells. The cytotoxic T cell releases cytokines leading to classical IM symptoms.…”