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Epstein-Barr virus: symptoms and treatment, manifestations in children

Epstein-Barr virus (EBV infection) is one of the newest terms in medicine. And although VEB infection is infected with 90% of the population and more, there is still no complete information about the effect of the virus on the body.

You can live all your life without even knowing about his presence, or you can learn about infection when you detect a serious illness.

So, the Epstein-Barr virus: a fashionable diagnosis that pulls money for expensive drugs, or is it really a serious problem that requires increased attention?


Epstein-Barr virus - what is it?

Epstein-Barr virus is a microorganism from the family of herpes viruses, called type 4 herpes. The virus infects B-lymphocytes, but does not destroy them, but transforms them.

EBV can be compared with a parasite that does not kill its carrier (lymphocytes), but only uses it for more insidious purposes. The infection affects not only the immune system, but also damages the central nervous system and is able to penetrate all organs.

Epstein-Barr virus

Herpes virus type 4 is distributed exclusively among people (including patients with asymptomatic forms of infection) in the following ways:

  1. Airborne - in contact with saliva or mucus from the patient's nasopharynx;
  2. Sexual and blood transfusion - through sexual contact or blood transfusion / bone marrow transplantation from an infected person;
  3. Intrauterine - a woman's EBV disease during pregnancy leads to the formation of fetal malformations (earlier contact with the infection does not pose such a serious threat to the fetus).

Features of infection with EBV:

  • Infection usually occurs in infancy (when kissing the mother).
  • Although EBV is contagious, infection occurs only through close contact between an infected person and a healthy one. That is why the disease is called the kissing disease.
  • The typical symptoms of Epstein-Barr virus in children are frequent catarrhal diseases and inflammation of the upper respiratory tract (sinusitis, tonsillitis, rhinitis), which are difficult to undergo traditional treatment.
  • In adults, the presence of EBV infection can be suspected with constant fatigue, weakness in the morning. It is a herpetic infection that often provokes chronic fatigue syndrome.

Recent medical studies have shown that the Epstein-Barr virus can trigger processes in the body that lead to severe and sometimes incurable diseases: diabetes mellitus , rheumatoid arthritis , autoimmune thyroiditis .

The virus, initially affecting the lymphoid tissue (B-lymphocytes) and epithelial cells of the salivary glands and the nasopharyngeal region, can multiply to a minimum and do not manifest themselves for a long time by external symptoms (latent course).

Any condition that causes an immune weakness and an inadequate immune response (autoimmune reaction) serves as a push to active reproduction. . An imbalance of the immune system links — a decrease in the level of T-lymphocytes and an increase in B-lymphocytes — further provokes serious disturbances in the division and maturation of cells of various organs and often leads to oncology .

VEB infection can occur:

  • Acute and chronic;
  • With typical and hidden (asymptomatic form) manifestations, lesions of various internal organs;
  • By mixed type - most often in combination with cytomegalovirus.

Diseases Caused by Epstein-Barr Virus

Epstein Barrier virus symptoms VEB infection manifests itself in three scenarios: primary infection on the background of immunodeficiency, sluggish current infection or activation of latent VEB infection with a sharp decrease in immune protection (surgery, cold, stress, etc.). As a result, the virus can provoke:

  • infectious mononucleosis ;
  • Hodgkin's lymphoma ( lymphogranulomatosis ) and its non-Hodgkin forms;
  • nasopharyngeal carcinoma;
  • herpes of the skin and mucous membranes - herpetic eruptions on the lips, shingles, herpetic sore throat , genital herpes ;
  • chronic fatigue syndrome;
  • Burkitt's lymphoma - a cancerous tumor affecting the jaw, kidneys, retroperitoneal lymph nodes and ovaries;
  • oncology of the digestive tract;
  • leukoplakia - the appearance of white spots on the skin and mucous membranes, with their high bleeding;
  • severe damage to the liver, heart and spleen;
  • autoimmune diseases - lupus erythematosus, rheumatoid arthritis, multiple sclerosis ;
  • blood diseases - malignant anemia, leukemia, thrombocytopenic purpura .

Types of EBV infection

Epstein-Barr virus produces several specific proteins (antigens):

  1. Capsid (VCA) - antigen to the inner protein content of the herpes virus;
  2. Membrane (MA) - protein agents that are directed to the shell of a viral substance;
  3. Nuclear (EBNA) is an antigen that controls the reproduction of the virus and prevents its death.

In response to antigen synthesis, the immune system produces antibodies to the Epstein-Barr virus, which serve as an indicator of the stage of the disease. Their presence in the blood and the amount varies depending on the stage of the disease:

— антитела к герпесу 4 типа IgМ — менее 20 Ед/мл, IgG — менее 20 Ед/мл. In the absence of infection - antibodies to herpes type 4 IgM - less than 20 U / ml, IgG - less than 20 U / ml.

— выявляются лишь антитела к капсидному антигену вируса Эпштейна-Барр (анти-VCA IgМ более 40 Ед/мл). At the early stage of the disease , only antibodies to the Epstein-Barr capsid antigen (anti-VCA IgM more than 40 U / ml) are detected. Maximum performance is achieved at 1-6 weeks. from the onset of the disease, and their normalization takes 1-6 months. The presence of IgM in the blood indicates an active infection.

— появляются антибелки к VCA IgМ и VCA IgG. In acute cases , anti-proteins to VCA IgM and VCA IgG appear. The IgG class IgG antibodies with the Epstein-Barr virus are positive in the acute phase and show more than 20 U / ml and reach a maximum value by 2 months from the onset of the disease, they decrease in the process of recovery (several more years can be detected).

The more acute the infection is during the initial infection, the higher the titer of anti-VCA IgG.

— синтезируются все типы антител (VCA IgМ, VCA IgG и EBNA IgG). In the persistent stage - all types of antibodies are synthesized (VCA IgM, VCA IgG and EBNA IgG). The emergence of IgG-class antibodies to the nuclear protein EBNA antigen indicate the beginning of the regression of the disease and a speedy recovery. Their titer is increased by 3-12 months. disease and continues to be held at high numbers for several years.

In the absence of painful symptoms of anti-EBNA IgG in the blood, state the fact of a previous illness, possibly in asymptomatic form.

Symptoms of Epstein-Barr virus

Epstein Barrier virus symptoms

Symptoms of infection with Epstein-Barr virus, the duration of the course of the disease - depends on the form of the disease and the direction of the viral "stroke".

Primary infection can asymptomatically enter the carrier phase, signs of viral presence are detected only by serological examination of blood.

In case of erased course, the traditional treatment of ARVI in children with Epstein-Barr virus does not bring a quick recovery.

In other cases, an acute disease with severe symptoms or a sluggish current infection with chronic pathological disorder occurs. Sometimes a generalized form develops with severe damage to organs and systems.

Infectious mononucleosis

From infection to the appearance of the first signs of the disease, 5 - 45 days pass. The main symptoms of mononucleosis:

  • Catarrhal phenomena - friability of the tonsils and hyperemia of the palatine arches (symptoms of angina), clear or purulent discharge from the nose, ulcerative stomatitis.
  • Intoxications - from the first days of the disease significant hyperthermia (above 38C), chills, joint pain, weakness. This picture lasts 1-4 weeks.
  • Enlarged lymph nodes - found after 7 days from the onset of the disease, painless and dense. Palpated in the neck: occipital, submandibular, axillary, sub-and supraclavicular.
  • Enlarged liver - 2 fingers (found when tapping) a week later from the appearance of the first signs of the disease. Accompanied by abdominal pain, lack of appetite, nausea, jaundice (yellowish skin and sclera, discolored stools, dark urine).
  • Enlargement of the spleen - significant splenomegaly accompanied by pain in the left side.

Recovery does not occur before 2-3 weeks. With a gradual improvement in well-being, there may be periods of acute illness. Periodic recurrence of symptoms indicates weakness of the immune system. Recovery may take 1.5 years.

Chronic Fatigue Syndrome

A striking example of the symptoms of sluggish current EBV infection. Patients constantly complain of weakness, even after a full sleep. Temperatures up to 37.5 ° C for no apparent reason, headache, muscle and joint pain are often perceived as a cold.

Moreover, this state continues for a long time, and against the background of poor sleep and mood swings, an exhausted body reacts with depression or psychosis.

Performance also noticeably suffers in adults. In children, there is a marked decrease in memory, confusion and inability to concentrate.

Generalized VEB infection

Generalized defeat of the virus occurs against the background of a significant failure of immunity. After the acute course of infectious mononucleosis may develop:

  • severe pneumonia accompanied by respiratory failure;
  • inflammation of the lining of the heart (fraught with cardiac arrest);
  • meningitis , encephalitis (threat of swelling of the brain);
  • toxic hepatitis and liver failure;
  • rupture of the spleen;
  • DIC (intravascular blood coagulation);
  • damage to lymph nodes throughout the body.

Often, the generalization of EBV infection is accompanied by a bacterial attack, which leads to sepsis and is fraught with death.

Treatment of Epstein-Barr virus, drugs

Treatment of Epstein-Barr virus, drugs

To completely eliminate EBV, no specific drugs have been created. Treatment of the Epstein-Barr virus is reduced to reducing the infection, balancing the immune system and preventing complications. Drug therapy depends on the type of immune response to a viral attack and includes:

  1. Antiviral drugs - Granciclovir, Valacyclovir, Famciclovir, Acyclovir (the least effective), a course of at least 2 weeks;
  2. Interferons and immunoglobulins - IFNR is most effective;
  3. Thymus hormones (Timalin, Timogen) and immunomodulators (Dekaris, Likopid) - increased T-lymphocyte levels and reduced B-cells);
  4. Corticosteroids (Prednisolone, Dexamethasone) and cytotoxic drugs - in an autoimmune reaction.

At the same time, symptomatic treatment and antibiotic therapy with Sumamed or Cefazolin (according to indications) are carried out. Be sure to adhere to a healthy sleep pattern, good nutrition, avoiding alcohol and the exclusion of stressful situations.

The effectiveness of treatment is confirmed by the normalization of blood serology.


For most patients in whom Epstein-Barr virus has been detected, the prognosis is favorable. It should only be attentive to their health and do not delay with the advice of a doctor when there are signs of indisposition.

  • The main criterion for success and the prevention of severe consequences is to maintain immunity at a sufficient level.

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