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Epstein-Barr virus infection in the neonatal period and in childhood
Insights
This study explored Epstein-Barr virus (EBV) infections in newborns and young children, suggesting the possibility of abortive EBV infections in early life. Exchange transfusions likely do not transmit EBV due to existing antibodies.
Area of Science:
- Pediatrics
- Virology
- Epidemiology
Background:
- Epstein-Barr virus (EBV) is a common human herpesvirus.
- Understanding congenital, neonatal, and early childhood EBV infections is crucial for public health.
- Previous studies have not fully characterized early-life EBV infections.
Purpose of the Study:
- To detect and characterize congenital, neonatal, and early childhood EBV infections.
- To investigate the possibility of abortive primary EBV infection in early life.
- To assess EBV transmission via exchange transfusion.
Main Methods:
- Prospective sero-epidemiological study.
- Inclusion of newborns, mothers, hospitalized infants, and their families.
- Leukocyte culture for EBV detection.
- Serological testing for EBV antibodies.
Main Results:
- Evidence suggests abortive primary EBV infection in early life, with seroconversion in some infants without significant illness.
- Infectious mononucleosis was rare, and seroreversion occurred in some early childhood cases.
- EBV antibodies did not consistently persist after exchange transfusions, suggesting limited transmission.
Conclusions:
- Abortive EBV infection may occur in early life.
- Congenital or neonatal EBV infection via exchange transfusion could not be definitively proven.
- Maternal antibodies likely prevent parenteral EBV transmission during exchange transfusion.
Abstract:
In an attempt to detect and characterize congenital, neonatal and early childhood EBV infections, a prospective sero-epidemiological study was undertaken in 112 newborn infants and their mothers, 25 additional newborns undergoing exchange transfusion, 114 randomly selected hospitalized infants aged 0 to 3 years, and 109 siblings and parents of these infants. Leukocyte culture was attempted in all the newborns and in 25 pre- and post-transfusion.The findings of EBV seroconversion in six patients without clearly apparent illness, infectious mononucleosis in only one case with significant EBV antibody rise, seroreversion in three cases in early childhood, higher newborn than maternal EBV antibody titres in three cases and the establishment of two permanent lymphoblastoid cell lines from newborns following exchange transfusion raise the possibility of abortive primary EBV infection in early life. Congenital or neonatal infections following exchange transfusions, however, could not be substantiated with certainty since the EBV antibodies did not persist at follow-up except possibly in two cases. Parenteral transmission of the EB virus by exchange transfusion at birth is probably prevented by the presence of EBV antibodies in either donor or recipient.