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Infants Younger Than 24 Months With Severe Malaria Have a Serologic Profile of Active Infection With Epstein-Barr

Wayne T Cheng1,2,3, Balotin Fogang4, Aarti Jain5

  • 1Department of Infectious Diseases, College of Veterinary Medicine.

The Journal of Infectious Diseases
|May 15, 2026
PubMed

Insights

Primary Epstein Barr Virus (EBV) infection in infants may increase the risk of severe malaria. Early EBV targeting could protect young children in malaria-endemic regions from severe falciparum malaria.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Pediatrics

Background:

  • Primary Epstein Barr Virus (EBV) infection, typically causing infectious mononucleosis in adolescents, is often asymptomatic in young children in malaria-endemic areas.
  • Infants with primary EBV infection experience temporary humoral immune suppression, raising questions about its impact on malaria susceptibility.
  • The relationship between EBV infection and severe malaria development in infants remains largely unknown.

Purpose of the Study:

  • To investigate whether Epstein Barr Virus (EBV) infection in infants (6-24 months) is associated with an increased risk of severe malaria.
  • To analyze the impact of active EBV infection on anti-Plasmodium falciparum (Pf) antibody responses in infants.

Main Methods:

  • A cross-sectional study involving 195 infants (6-24 months) in Cameroon.
  • Infants were assessed for Plasmodium falciparum (Pf) parasitemia and malaria severity using microscopy/RDT and WHO criteria.
  • Epstein Barr Virus (EBV) infection status was determined serologically, and anti-Pf antibody responses (magnitude, breadth, invasion-blocking capacity) were quantified.

Main Results:

  • 24% of infants had active Epstein Barr Virus (EBV) infection.
  • Children with active EBV infection showed a higher proportion of severe malaria cases.
  • Elevated magnitude and breadth of anti-Pf antibody responses with increased invasion-blocking capacity were observed in children with active EBV.

Conclusions:

  • Primary Epstein Barr Virus (EBV) infection may serve as a risk factor for severe malaria in infants aged 6-24 months.
  • Targeting EBV infection in young children could potentially reduce the incidence of severe falciparum malaria in endemic areas.
Abstract

Keywords:
P falciparumEBVcoinfectionhumoral responseprotein microarray

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