Horwitz C A, Henle W, Henle G, Schmitz H
Am J Med. 1975 Mar;58(3):330-8. doi: 10.1016/0002-9343(75)90599-9.
Previous reports have emphasized that the transitory antibody responses to Epstein-Barr virus (EBV)-induced early antigens (EA) in the course of infectious mononucleosis are usually directed against the D (diffuse) component of the EA complex. In this report clinical and serologic data have been presented on 14 patients with infectious mononucleosis who responded either solely with antibodies to the R (restricted) component of the EA complex or revealed anti-R after the initial anti-D responses had subsided weeks or months after onset of the disease. Anti-R persisted usually for many months , as many as 39, but in some patients it was no longer detectable in late follow-up serum spectimens. Although many patients had an unremarkable course of illness, others, mostly those with late anti-R responses, showed unusual or protracted clinical manifestations and several complained over periods of 4 to 28 months of recurrent symptoms resembling those experienced during the acute stage of disease. The presence of anti-R and the relatively high continuous titers of antibodies to EB viral capsid antigens (VCA) may reflect a more than usual, persistent EBV activity which, in turn, may account for the recurrent symptoms.
以往的报告强调，在传染性单核细胞增多症病程中，针对爱泼斯坦-巴尔病毒（EBV）诱导的早期抗原（EA）的短暂抗体反应通常针对EA复合物的D（弥漫性）成分。在本报告中，呈现了14例传染性单核细胞增多症患者的临床和血清学数据，这些患者要么仅产生针对EA复合物R（局限性）成分的抗体，要么在疾病发作数周或数月后最初的抗D反应消退后出现抗R。抗R通常持续数月，多达39个月，但在一些患者中，后期随访血清样本中不再检测到。尽管许多患者病程无异常，但其他患者，主要是那些出现晚期抗R反应的患者，表现出异常或迁延的临床表现，有几位患者在4至28个月期间抱怨反复出现类似急性期疾病时经历的症状。抗R的存在以及针对EB病毒衣壳抗原（VCA）的抗体持续相对较高的滴度可能反映了EBV比平常更持久的活性，这反过来可能解释了反复出现的症状。
