Bertram G, Dreiner N, Krueger G R, Ramon A, Ablashi D V, Salahuddin S Z, Balachandram N
ENT Clinic Dortmud, University Witten-Herdecke, F.R.G.
In Vivo. 1991 May-Jun;5(3):271-9.
Clinical infectious mononucleosis (IM) represents a benign self-limited form of lymphoproliferative disease which is usually caused by infection with Epstein-Barr virus (EBV). Microscopic characteristics of this lymphoproliferative disorder, however, are not ultimately specific for EBV infection, but can also be seen in infections with other lymphotropic viruses, especially of the herpesvirus family. Human herpesvirus-6 (HHV-6) infection can apparently be associated with a number of diseases also seen in EBV infection. Also, postinfectious chronic fatigue syndrome (PICFS) which may follow IM is in more than 60% of the cases accompanied by persistent active HHV-6 infection. We thus screened serologically 215 cases of acute IM for evidence for infection with EBV, HHV-6 and CMN. Patients were tentatively grouped into those having primary infection or reactivated (probably non-primary) infections. Cases were followed for two years to monitor changes in titers. Of all 215 cases, 211 (98.1%) were positive for EBV, 137 (63.7%) for primary infections, 21 (9.8%) for reactivated infection, and 53 (24.6%) for latent EBV. Thirty-three (15.3%) cases had primary HHV-6 infection, 63 (29.3%) active or reactivated HHV-6 infection, and 71 (33.9%) latent HHV-6. Double active EBV and HHV-6 infection, including primary and reactivated infections, amounted to 89 (39.5%) cases. Cytomegalovirus (CMV) antibody titers were found in 81 (37%) cases, 48 (22.3%) of which indicated latent infection and 33 (15.3%) active infection. Only two cases had evidence of active CMV infection alone, 1 cases of active CMV and HHV-6 infection. Serologic titers in 12 (5.6%) cases indicated combined active infection with CMV, EBV and HHV-6.(ABSTRACT TRUNCATED AT 250 WORDS)
临床传染性单核细胞增多症（IM）是一种良性自限性淋巴增殖性疾病，通常由感染爱泼斯坦-巴尔病毒（EBV）引起。然而，这种淋巴增殖性疾病的微观特征并非EBV感染所特有，在其他嗜淋巴细胞病毒感染中也可见到，尤其是疱疹病毒科的病毒。人类疱疹病毒6型（HHV-6）感染显然也可与一些EBV感染中出现的疾病相关。此外，IM后可能出现的感染后慢性疲劳综合征（PICFS）在60%以上的病例中伴有持续性HHV-6活跃感染。因此，我们对215例急性IM患者进行了血清学筛查，以寻找EBV、HHV-6和巨细胞病毒（CMV）感染的证据。患者初步分为原发性感染或再激活（可能是非原发性）感染两组。对病例进行了两年的随访，以监测滴度变化。在所有215例病例中，211例（98.1%）EBV阳性，137例（63.7%）为原发性感染，21例（9.8%）为再激活感染，53例（24.6%）为EBV潜伏感染。33例（15.3%）病例有原发性HHV-6感染，63例（29.3%）有活跃或再激活的HHV-6感染，71例（33.9%）有HHV-6潜伏感染。EBV和HHV-6双重活跃感染，包括原发性和再激活感染，共89例（39.5%）。81例（37%）病例检测到巨细胞病毒（CMV）抗体滴度，其中48例（22.3%）提示潜伏感染，33例（15.3%）提示活跃感染。仅2例有单独活跃CMV感染的证据，1例有活跃CMV和HHV-6感染。12例（5.6%）病例的血清学滴度提示CMV、EBV和HHV-6合并活跃感染。（摘要截短于250字）
