Development of cell-mediated immunity to Epstein-Barr herpesvirus in infectious mononucleosis as shown by leukocyte migration inhibition

Eight patients with infectious mononucleosis, aged between 8 and 24, were studied for cell-mediated immunity by the in vitro leukocyte migration inhibition test at acute and convalescent stages. Follow-up studies were also carried out at up to 4 months after clinical illness. Cell-mediated immunity to Epstein-Barr virus (EBV) in the peripheral leukocytes from these patients was absent or incipient in all cases during the acute phase, although it was present in lymphocytes from a biopsied lymph node obtained from one of the patients. In contrast, cell-mediated immunity to EBV was detected readily in peripheral leukocytes obtained during convalescence and in the follow-up studies. A blocking factor that abrogated leukocyte migration inhibition induced by EBV antigen was detected in acute and convalescent sera obtained from six of eight patients, whereas serum antinuclear autoantibodies were detected in the two patients whose sera failed to block leukocyte migration inhibition. When sera were fractionated, this blocking effect was observed only in the serum immunoglobulin G fractions. In follow-up studies, neither the blocking factor nor the antinuclear autoantibodies were found in the sera collected.