Primary epstein‐barr virus infections in african infants. I. Decline of maternal antibodies and time of infection

Biggar, Robert J.; Henle, Werner; Fleisher, Gary; Böcker, J.; Lennette, Evelyne T.; Henle, Gertrude

doi:10.1002/ijc.2910220304

Cited by 150 publications

(85 citation statements)

References 18 publications

(13 reference statements)

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“…This pattern has also been observed in other studies and is due to preexisting maternal antibodies active in infants under six-months-old (Leogrande et al, 1993). Longitudinal serological data have shown that maternal anti-EBV protection usually lasts for 3-4 months (Biggar et al, 1978;Chan et al, 2001). Once the level of maternal antibodies declines, infants begin to seroconvert.…”

Section: Discussionsupporting

confidence: 83%

Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

Suntornlohanakul¹,

Wanlapakorn²,

Vongpunsawad³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Epstein-Barr virus (EBV) is an extremely common herpesvirus that may cause asymptomatic infection or various diseases, including infectious mononucleosis, certain lymphoproliferative diseases and several types of neoplasms. Vaccine development is an important strategy to reduce the burden of EBV-associated diseases and the timing of vaccinations should be before primary infection occurs. In the past, more than 90% of Thai children were infected with EBV in early childhood. Now, due to the improved healthcare system in Thailand, we aim to determine current prevalence of EBV infection among people in different age groups. A total of 538 sera were collected from residents of Khon Kaen province in northeastern Thailand for detecting anti-EBV IgG. Sera of infants under 2-years-old were also tested for anti-EBV IgM and EBV-DNA. The prevalence of anti-EBV IgG was 47.1% (95% CI: 23.3-70.8) in infants aged 0-6 months, 34.9% (95% CI: 23.1-46.7) in those aged 6-24 months, 87.9% (95% CI: 79.5-96.3) in children aged 3-5 years and then maintained at above 95% through adulthood. These seropositivity rates among Thai children remain similar to those found in a previous study conducted 20 years ago. Thai children are still exposed to EBV from an early age. Therefore, a prophylactic vaccine should be given within the first two years of life.

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Section: Discussionsupporting

confidence: 83%

Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

Suntornlohanakul¹,

Wanlapakorn²,

Vongpunsawad³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…One important eBL co-factor, Epstein-Barr virus infection, is evenly distributed in the population and infection occurs early in childhood. 21,22 Our consistent findings, therefore, may imply clustering of other environmental or socio-cultural eBL co-factors, although potential reporting bias must also be assessed. Neither high-risk cluster included administrative units in Siaya District, as initially hypothesized.…”

Section: Spatial Clusteringmentioning

confidence: 79%

Spatial clustering of endemic Burkitt's lymphoma in high‐risk regions of Kenya

Rainey

Omenah

Sumba

et al. 2006

Intl Journal of Cancer

103

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Endemic Burkitt's lymphoma (eBL), the most common childhood cancer in sub‐Saharan Africa, occurs at a high incidence in western Kenya, a region that also experiences holoendemic malaria. Holoendemic malaria has been identified as a co‐factor in the etiology of this cancer. We hypothesized that eBL may cluster spatially within this region. Medical records for all eBL cases diagnosed from 1999 through 2004 at Nyanza Provincial General Hospital were reviewed for case residential information to examine this hypothesis. Two cluster detection methods, Anselin's Local Moran test for spatial autocorrelation and a spatial scan test statistic, were applied to this residential data to determine whether statistically significant high‐ and low‐risk areas were present in the Province. During the 6‐year study period, 272 children were diagnosed with eBL, with an average annual incidence of 2.15 cases per 100,000 children. Using Empirical Bayes smoothed rates, the Local Moran test identified 1 large multi‐centered area of low eBL risk (p‐values < 0.01) and 2 significant multi‐centered clusters of high eBL risk (p‐values < 0.001). The spatial scan detected 3 small independent low‐risk areas (p‐values < 0.02) and 2 high‐risk clusters (p‐values = 0.001), both similar in location to those identified from the Local Moran analysis. Significant spatial clustering of elevated eBL risk in high‐malaria transmission regions and of reduced incidence where malaria is infrequent suggests that malaria plays a role in the complex eBL etiology, but that additional factors are also likely involved. © 2006 Wiley‐Liss, Inc.

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“…Clinically, elevated levels of anti-VCA and anti-EBNA1 immunoglobulin G (IgG) antibodies have been used as evidence of past infection (9), while the presence of IgG antibodies to the EBV early antigens (EAd and Zta) generally reflects recent or reactivated infections (10,11). Although EBV-specific antibody patterns reflect the dynamics of EBV activity in adults, few studies have addressed this issue in infants and children (3,(12)(13)(14)(15) or in newborns (16,17). More importantly, no comparison to maternal antibody levels has been made and there has been no analysis of how maternal malaria infections impact transplacental transfer of EBV-specific antibodies.…”

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confidence: 99%

Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy

Ogolla

Daud

Asito

et al. 2015

Clin Vaccine Immunol

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h Over 35% of children in a region of malaria endemicity are infected with Epstein-Barr virus (EBV) by 6 months of age. This susceptibility may be linked to impaired transplacental transfer of antibodies. In this study, we determined the effect of malaria exposure during pregnancy on the transfer of EBV-specific maternal antibodies in a region of western Kenya that experiences endemic malaria. Pregnant mothers were recruited and followed up until delivery to determine levels of neonatal malaria exposure. Levels of EBV lytic (viral capsid antigen [VCA], Z transcriptional activator [Zta], and early diffuse antigen complex [EAd]) and EBV latent (EBV nuclear antigen-1 (EBNA1]) and tetanus-specific IgG antibodies were measured in 70 paired maternal and cord blood samples using a Luminex-bead-based assay. A high proportion (63%) of the infants were exposed to malaria in utero. Levels of EBV-and tetanus-specific antibodies were similar in malaria-infected mothers and in mothers who had no detectable malaria infection. Malaria-exposed neonates had significantly lower levels of anti-EBNA1, anti-Zta, and anti-EAd antibodies than were seen in their mothers. In utero malaria exposure resulted in significant reductions in transplacental transfer of anti-VCA-p18 and anti-EBNA1 antibodies of 13% and 22%, respectively. Neonates received significantly low levels of anti-Zta and anti-EAd antibodies irrespective of malaria exposure levels. In multivariate analysis, in utero malaria exposure was associated with a significant reduction in the transfer of anti-VCA-p18 and anti-EBNA1 antibodies to the neonates (P ‫؍‬ 0.0234 and P ‫؍‬ 0.0017, respectively). Malaria during pregnancy results in differential levels of transfer of EBV-specific antibodies from the mother to the fetus. The impaired transplacental transfer of some antibodies may lead to the malaria-exposed neonates being susceptible to early EBV infection. E ndemic Burkitt's lymphoma (eBL) is a distinct form of nonHodgkin's lymphoma and is the most common pediatric malignancy in regions of malaria endemicity of sub-Saharan Africa (1). Both infection with Epstein-Barr virus (EBV) and repeated episodes of Plasmodium falciparum malaria are known risk factors for eBL (2), but the mechanism(s) by which these two agents interact to promote the emergence of malignant B cell clones has not been elucidated. Recently, we found that infants from a region of malaria endemicity of western Kenya were infected with EBV by 6 months of age (3). Living in regions of malaria endemicity was a predictor of this early age of primary infection. This aberrant primary EBV infection may set the stage for lymphoma development, as previously hypothesized (4-6).The lytic and latent phases of the EBV life cycle induce distinct antibodies in response to specific lytic and latent antigens. Anti-EBV nuclear antigen-1 (EBNA1) antibodies are produced against EBNA1, the only antigen expressed in latently infected memory B cells and in eBL tumors (7). Anti-viral capsid antigen (anti-VCA), anti-early antigen (ant...

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Primary epstein‐barr virus infections in african infants. I. Decline of maternal antibodies and time of infection

Cited by 150 publications

References 18 publications

Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

Seroprevalence of Anti-EBV IgG among Various Age Groups from Khon Kaen Province, Thailand

Spatial clustering of endemic Burkitt's lymphoma in high‐risk regions of Kenya

Reduced Transplacental Transfer of a Subset of Epstein-Barr Virus-Specific Antibodies to Neonates of Mothers Infected with Plasmodium falciparum Malaria during Pregnancy

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