Department of Pediatrics, HealthPartners, Bloomington.
Department of Laboratory Medicine and Pathology, University of Minnesota Medical School.
Clin Infect Dis. 2014 Aug 15;59(4):501-8. doi: 10.1093/cid/ciu342. Epub 2014 May 11.
Primary Epstein-Barr virus (EBV) infection affects the host differently according to when in life it is acquired. Understanding risk factors for infection could be important for disease prevention, and the age-specific prevalence of infection must be known to optimize use of a prophylactic vaccine.
Children 18 months to 19.9 years of age who had blood drawn for medical indications during an outpatient visit were eligible. Sera were tested for immunoglobulin G antibodies against EBV viral capsid antigen by enzyme immunoassay. Family demographic and socioeconomic data were obtained via scripted telephone questionnaires.
Consent was given for 876 of 914 (96%) subjects approached. Sera were available for 782 of 876 (89%) subjects and demographic/socioeconomic data obtained for 705 (90%) of them. Antibody prevalence, adjusted for age and sex, was as follows: non-Hispanic blacks, 74%; Asians, 62%, multiracial children, 54%; Hispanics, 50%; and non-Hispanic whites, 26%. The pattern of increases in antibody prevalence with age differed significantly by race/ethnicity, and was most divergent in the 2 youngest age groups. Adjusted EBV antibody prevalence decreased with greater household education among non-Hispanic whites, but was not associated with any other socioeconomic factor. In 42 of 51 (82%) families with >1 child in the study, the siblings' EBV antibody status was concordant (bootstrap P < .001).
Racial/ethnic differences in EBV antibody prevalence and concordance of antibody status among siblings prompt us to speculate that both genetics and family environment contribute to acquisition of EBV infection. The ideal age to give a prophylactic vaccine may differ according to race/ethnicity.
原发性 EBV（Epstein-Barr virus，EBV）感染根据其在生命中的感染时间而对宿主产生不同的影响。了解感染的危险因素对于疾病预防可能很重要，并且必须了解感染的年龄特异性患病率，以优化预防性疫苗的使用。
在门诊就诊期间因医疗原因抽取血液的 18 个月至 19.9 岁的儿童符合条件。通过酶免疫测定法检测针对 EBV 衣壳抗原的 IgG 抗体。通过脚本电话问卷获得家庭人口统计学和社会经济数据。
在 914 名被接触的对象中，876 名（96%）同意参加。在 876 名对象中，有 782 名（89%）获得了血清，对其中 705 名（90%）进行了人口统计学/社会经济数据的收集。经年龄和性别调整后的抗体流行率如下：非西班牙裔黑人，74%；亚洲人，62%，多种族儿童，54%；西班牙裔，50%；和非西班牙裔白人，26%。不同种族/族裔的抗体流行率随年龄增加的模式差异显著，在年龄最小的两个年龄组中差异最大。在非西班牙裔白人中，家庭受教育程度越高，调整后的 EBV 抗体流行率越低，但与任何其他社会经济因素无关。在研究中，42 个（82%）有多个孩子的家庭中，兄弟姐妹的 EBV 抗体状态是一致的（bootstrap P <.001）。
EBV 抗体流行率的种族/族裔差异以及兄弟姐妹之间抗体状态的一致性促使我们推测，遗传和家庭环境都有助于 EBV 感染的发生。理想的预防性疫苗接种年龄可能因种族/族裔而异。
